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      Blood mercury levels and fish consumption in pregnancy: Risks and benefits for birth outcomes in a prospective observational birth cohort

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          Abstract

          Background

          To avoid exposure to mercury, government advice on fish consumption during pregnancy includes information on fish species to avoid and to limit, while encouraging consumption of least two portions of fish per week. Some women may, however, chose to avoid fish completely during pregnancy despite potential benefits to the fetus.

          Objectives

          Our aims were to evaluate the effects of blood mercury levels in pregnant women on birth outcomes in the UK, and to compare outcomes in those who ate fish with those who did not.

          Methods

          Pregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Hg by inductively coupled plasma dynamic reaction cell mass spectrometry (n = 4044). Fish intake was determined by a food frequency questionnaire during pregnancy. Data collected on the infants included anthropometric variables and gestational age at delivery. Regression models were adjusted for covariates using SPSS v23.

          Results

          There were no significant associations of maternal blood Hg level with birthweight, head circumference or crown–heel length in adjusted linear regression models. Similarly, there were no increased odds of low birthweight or preterm delivery in adjusted logistic regression models. When the models were repeated after stratification into fish-eaters and there were no associations except for a negative association with birthweight in non-fish-eaters (unstandardised B coefficient −58.4 (95% confidence interval −113.8, −3.0) g, p = 0.039).

          Conclusion

          Moderate mercury levels in pregnancy were not associated with anthropometric variables, or on the odds of low birthweight or preterm birth. Fish consumption may have a protective effect on birthweight. Consumption of fish in line with government guidelines during pregnancy should be encouraged.

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          Most cited references34

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          Estimation of Average Concentration in the Presence of Nondetectable Values

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            Maternal fish intake during pregnancy, blood mercury levels, and child cognition at age 3 years in a US cohort.

            The balance of contaminant risk and nutritional benefit from maternal prenatal fish consumption for child cognitive development is not known. Using data from a prospective cohort study of 341 mother-child pairs in Massachusetts enrolled in 1999-2002, the authors studied associations of maternal second-trimester fish intake and erythrocyte mercury levels with children's scores on the Peabody Picture Vocabulary Test (PPVT) and Wide Range Assessment of Visual Motor Abilities (WRAVMA) at age 3 years. Mean maternal total fish intake was 1.5 (standard deviation, 1.4) servings/week, and 40 (12%) mothers consumed >2 servings/week. Mean maternal mercury level was 3.8 (standard deviation, 3.8) ng/g. After adjustment using multivariable linear regression, higher fish intake was associated with better child cognitive test performance, and higher mercury levels with poorer test scores. Associations strengthened with inclusion of both fish and mercury: effect estimates for fish intake of >2 servings/week versus never were 2.2 (95% confidence interval (CI): -2.6, 7.0) for the PPVT and 6.4 (95% CI: 2.0, 10.8) for the WRAVMA; for mercury in the top decile, they were -4.5 (95% CI: -8.5, -0.4) for the PPVT and -4.6 (95% CI: -8.3, -0.9) for the WRAVMA. Fish consumption of < or =2 servings/week was not associated with a benefit. Dietary recommendations for pregnant women should incorporate the nutritional benefits as well as the risks of fish intake.
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              Dietary selenium's protective effects against methylmercury toxicity.

              Dietary selenium (Se) status is inversely related to vulnerability to methylmercury (MeHg) toxicity. Mercury exposures that are uniformly neurotoxic and lethal among animals fed low dietary Se are far less serious among those with normal Se intakes and are without observable consequences in those fed Se-enriched diets. Although these effects have been known since 1967, they have only lately become well understood. Recent studies have shown that Se-enriched diets not only prevent MeHg toxicity, but can also rapidly reverse some of its most severe symptoms. It is now understood that MeHg is a highly specific, irreversible inhibitor of Se-dependent enzymes (selenoenzymes). Selenoenzymes are required to prevent and reverse oxidative damage throughout the body, particularly in the brain and neuroendocrine tissues. Inhibition of selenoenzyme activities in these vulnerable tissues appears to be the proximal cause of the pathological effects known to accompany MeHg toxicity. Because Hg's binding affinities for Se are up to a million times higher than for sulfur, its second-best binding partner, MeHg inexorably sequesters Se, directly impairing selenoenzyme activities and their synthesis. This may explain why studies of maternal populations exposed to foods that contain Hg in molar excess of Se, such as shark or pilot whale meats, have found adverse child outcomes, but studies of populations exposed to MeHg by eating Se-rich ocean fish observe improved child IQs instead of harm. However, since the Se contents of freshwater fish are dependent on local soil Se status, fish with high MeHg from regions with poor Se availability may be cause for concern. Further studies of these relationships are needed to assist regulatory agencies in protecting and improving child health. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Int J Hyg Environ Health
                Int J Hyg Environ Health
                International Journal of Hygiene and Environmental Health
                Urban & Fischer
                1438-4639
                1618-131X
                1 August 2016
                August 2016
                : 219
                : 6
                : 513-520
                Affiliations
                [0005]Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
                Author notes
                [* ]Corresponding author. Centre for Child and Adolescent Health, School of Social and Community Medicine, Oakfield House, Oakfield Grove, University of Bristol, Bristol BS8 2BN, UK. Caroline.m.taylor@ 123456bristol.ac.uk
                Article
                S1438-4639(16)30046-3
                10.1016/j.ijheh.2016.05.004
                4970655
                27252152
                358a7965-5466-41e4-b639-e0739782bad3
                © 2016 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 26 April 2016
                : 17 May 2016
                : 17 May 2016
                Categories
                Article

                alspac, avon longitudinal study of parents and children,b-hg, blood mercury,b-se, blood selenium,lbw, low birth weight,sga, small for gestational age,alspac,pregnancy,mercury,birth outcomes,fish consumption,guidelines

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