Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO programme

Emily Oken¹, Rashelle J Musci², Matthew Westlake³, Kennedy Gachigi⁴, Judy L Aschner^{5

6}, Kathrine L Barnes⁷, Theresa M Bastain⁸, Claudia Buss^{9

10}, Carlos A Camargo Jr¹¹, Jose F Cordero¹², Dana Dabelea¹³, Anne L Dunlop¹⁴, Akhgar Ghassabian¹⁵, Alison E Hipwell¹⁶, Christine W Hockett¹⁷, Margaret R Karagas¹⁸, Claudia Lugo-Candelas¹⁹, Amy E Margolis²⁰, Thomas G O'Connor²¹, Coral L Shuster²², Jennifer K Straughen²³, Kristen Lyall²⁴; program collaborators for Environmental influences on Child Health Outcomes

Affiliations

¹ Division of Chronic Disease research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, USA.
² Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ RTI International, Raleigh, NC, USA.
⁴ Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
⁶ Albert Einstein College of Medicine, Bronx, NY, USA.
⁷ Marshfield Clinic Research Institute, Marshfield, WI, USA.
⁸ Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
⁹ Department of Medical Psychology, Charité University of Medicine Berlin, Berlin, Germany.
¹⁰ Development, Health, Disease Research Program, University of California Irvine, Irvine, CA, USA.
¹¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
¹³ Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁴ Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
¹⁵ Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
¹⁶ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
¹⁷ Avera Research Institute, Sioux Falls, SD, USA.
¹⁸ Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
¹⁹ New York State Psychiatric Institute, New York, NY, USA.
²⁰ Columbia University Irving Medical center, New York, NY, USA.
²¹ Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
²² Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, RI, USA.
²³ Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
²⁴ AJ Drexel Autism Institute, Philadelphia, PA, USA.

PMID: 38410088
PMCID: PMC10993063
DOI: 10.1017/S136898002400051X

Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO programme

Emily Oken et al. Public Health Nutr. 2024.

. 2024 Feb 27;27(1):e94.

doi: 10.1017/S136898002400051X.

Authors

Affiliations

¹ Division of Chronic Disease research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA, USA.
² Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ RTI International, Raleigh, NC, USA.
⁴ Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Pediatrics, Joseph M. Sanzari Children's Hospital, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
⁶ Albert Einstein College of Medicine, Bronx, NY, USA.
⁷ Marshfield Clinic Research Institute, Marshfield, WI, USA.
⁸ Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
⁹ Department of Medical Psychology, Charité University of Medicine Berlin, Berlin, Germany.
¹⁰ Development, Health, Disease Research Program, University of California Irvine, Irvine, CA, USA.
¹¹ Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
¹² Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
¹³ Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁴ Department of Gynecology & Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
¹⁵ Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
¹⁶ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
¹⁷ Avera Research Institute, Sioux Falls, SD, USA.
¹⁸ Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
¹⁹ New York State Psychiatric Institute, New York, NY, USA.
²⁰ Columbia University Irving Medical center, New York, NY, USA.
²¹ Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
²² Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, RI, USA.
²³ Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
²⁴ AJ Drexel Autism Institute, Philadelphia, PA, USA.

PMID: 38410088
PMCID: PMC10993063
DOI: 10.1017/S136898002400051X

Abstract

Objective: n-3 fatty acid consumption during pregnancy is recommended for optimal pregnancy outcomes and offspring health. We examined characteristics associated with self-reported fish or n-3 supplement intake.

Design: Pooled pregnancy cohort studies.

Setting: Cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) consortium with births from 1999 to 2020.

Participants: A total of 10 800 pregnant women in twenty-three cohorts with food frequency data on fish consumption; 12 646 from thirty-five cohorts with information on supplement use.

Results: Overall, 24·6 % reported consuming fish never or less than once per month, 40·1 % less than once a week, 22·1 % 1-2 times per week and 13·2 % more than twice per week. The relative risk (RR) of ever (v. never) consuming fish was higher in participants who were older (1·14, 95 % CI 1·10, 1·18 for 35-40 v. <29 years), were other than non-Hispanic White (1·13, 95 % CI 1·08, 1·18 for non-Hispanic Black; 1·05, 95 % CI 1·01, 1·10 for non-Hispanic Asian; 1·06, 95 % CI 1·02, 1·10 for Hispanic) or used tobacco (1·04, 95 % CI 1·01, 1·08). The RR was lower in those with overweight v. healthy weight (0·97, 95 % CI 0·95, 1·0). Only 16·2 % reported n-3 supplement use, which was more common among individuals with a higher age and education, a lower BMI, and fish consumption (RR 1·5, 95 % CI 1·23, 1·82 for twice-weekly v. never).

Conclusions: One-quarter of participants in this large nationwide dataset rarely or never consumed fish during pregnancy, and n-3 supplement use was uncommon, even among those who did not consume fish.

Keywords: DHA; Fish; Pregnancy; n-3 fatty acid.

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Conflict of interest statement

None of the authors reports a conflict of interest.

Figures

**Fig. 1**
Likelihood of n-3 polyunsaturated supplement use in pregnancy according to fish consumption during pregnancy within the Environmental influences on Child Health Outcomes (ECHO) cohort

See this image and copyright information in PMC

References

1. Middleton P, Gomersall JC, Gould JF et al. (2018) Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev 11, CD003402. - PMC - PubMed
1. US Food and Drug Administration (2022) Advice about Eating Fish. FDA. https://www.fda.gov/food/consumers/advice-about-eating-fish (accessed July 2022).
1. US Department of Agriculture & US Department of Health and Human Services (2020) Dietary Guidelines for Americans, 2020–2025. 9th Edition. https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines... (accessed August 2022).
1. Koletzko B, Cetin I, Brenna JT et al. (2007) Dietary fat intakes for pregnant and lactating women. Br J Nutr 98, 873–877. - PubMed
1. US Food and Drug Administration (2014) Quantitative Assessment of the Net Effects on Fetal Neurodevelopment from Eating Commercial Fish (as Measured by IQ and Also by Early Age Verbal Development in Children). https://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm393211.htm (accessed August 2022).

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Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO programme

Affiliations

Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO programme

Authors

Affiliations

Abstract

Conflict of interest statement

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