The effect of maternal seafood consumption on perinatal outcomes: a systematic review and dose-response meta-analysis

Abstract

Observational studies have suggested inconsistent results between maternal seafood consumption and the risk of adverse birth outcomes. We aimed to explore the possible dose-response relationship between seafood consumption during pregnancy and perinatal outcomes. A systematic search was performed with the use of PubMed, Web of Science, Embase and Cochrane Library from inception to October 27, 2019. Random-effects model was used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Dose-response meta-analysis was carried out by using generalized least-squares regression and restricted cubic splines. Twenty-one studies with a total of 571641 participants were included in the analyses. A 45 g/day increment in seafood consumption was associated with a reduced risk of low birth weight (LBW) (OR: 0.65, 95% CI: 0.47 to 0.90) and small for gestational age (SGA) (OR: 0.84, 95% CI: 0.71 to 0.98). Additionally, there was a non-linear dose-response relationship between maternal seafood consumption and the risk of preterm birth (PTB), with no further benefit observed when intake above 45 g/day. The results for subtypes of seafood showed a modest J-shaped association between fatty fish and PTB, and the lowest risk was observed with the consumption of 30 g/day. In conclusion, higher total seafood consumption during pregnancy was associated with a lower risk of adverse birth outcomes, but the consumption of fatty fish should not exceed 30 grams per day. These findings could provide substantial evidence for dietary recommendations regarding seafood intake for pregnant women. This review was registered in PROSPERO (CRD42020152912).

Keywords:

• Low birth weight
• meta-analysis
• preterm birth
• seafood
• small for gestational age

Acknowledgements

We would like to acknowledge all participants who participated in this study.

Authors' contribution

ZR, QG, and LH designed the study; ZR, SW researched the databases; ZR, SW collected data; ZR, QG analyzed the data; ZR drafted the manuscript; QG, LH reviewed/edited the manuscript and contributed to the discussion. All authors approved the final manuscript for submission.

Disclosure statement

The authors declared no conflict of interest.

Additional information

Funding

This research was supported by the National Natural Science Foundation of China (L. H., No. 81773426).