Mamas on Bedrest: Fishing out the Facts

May 4th, 2011

When I was pregnant with each of my kids, I recall being warned to watch my fish consumption. In particular, I was advised to avoid eating shark, swordfish, king mackerel, tile fish and tuna steaks because regular consumption of these fish can lead to mercury accumulation in mama and baby. A huge tuna fish fan,  (I love it in salads!) I was also advised to avoid eating too much canned tuna for the same reasons (although canned tuna is reported to have less mercury than the tuna steaks!).

However, fish is a wonderful source lean protein and of Omega (healthy) Fatty Acids and should not be completely avoided during pregnancy.  The omega fatty acids are  key ingredients in healthy brain development of the growing fetus. So what fish is safe and what should mamas (Mamas on Bedrest in particular) know?

As was previously stated, fish contain essential fats that aid in fetal brain development. Since we’ve talked about the fish to avoid, what fish are safe for pregnant mamas to eat? According to the US FDA, it is safe for a pregnant woman to consume up to 12 ounces of fish per week. She should make her selections from commercially caught fish (which is usually lower in contaminants), such as wild salmon, sole, tilapia and trout. Mamas can also choose cold water fish such as haddock, cod, pollack,  and flounder. The “small fish” are also recommended such as anchovies, sardines and herrings. And if a mama has no aversions, other forms of seafood (such as scallops, clams, crabmeat, etc…) are good for her to eat as well.

So why am I trying to “hook” you on fish (okay, that was pretty bad!)? Because a recent study found that moderate fish intake may lower the risk for repeat preterm birth. There, do I have your attention now??

Fish Consumption, Erythrocyte Fatty Acids, and Preterm Birth

Dr. Mark Klebanoff, MD, MPH and his colleagues at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU) sought to estimate the association between fish intake and red blood cell omega-3 long-chain polyunsaturated fatty acids with preterm birth in a cohort of women at high risk because of at least 1 previous spontaneous preterm delivery. Participants completed a questionnaire regarding dietary fish consumption. Red Blood Cell fatty acids were measured at enrollment at 16 to 21 completed weeks of gestation. Linear and quadratic terms were used to model the association between fish intake and preterm delivery.

The Findings

“Eating fish has been associated with reductions in preterm birth, increased duration of pregnancy, or both reductions in preterm birth and increased duration of pregnancy in some but not in all studies; most studies have been conducted in unselected or low-risk women,” writes Klebanoff. “Several reports have found the association between fish consumption and pregnancy outcome to be nonlinear.”

In Klebanoff’s study, among women eating fish less than once per month, the probability of preterm birth was 48.6% vs 35.9% among women who reported more frequent fish consumption. For moderately frequent fish intake, defined as 3 servings per week, the adjusted odds ratio (OR) for preterm birth was 0.60. Women who ate more than 3 servings of fish per week had no further reduction in the risk for preterm birth.

Mamas, Eat Fish!

In this study, moderate fish intake (up to three meals per week) before 22 weeks of gestation was associated with a reduction in repeat preterm birth.  Eating fish more than 3 times per week did not seem to provide any additional benefit. These results support the recommendations of the U.S. Food and Drug Administration [FDA] and the American Congress of Obstetricians and Gynecologists [ACOG] for fish consumption during pregnancy.

Read the original article (hyperlinked in the first section title), or a summary from MedScape

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