Decline in fish consumption among pregnant women after a national mercury advisory☆
Section snippets
Materials and methods
We used an interrupted time series design16, 17 to estimate the impact of the advisory on total fish intake as well as consumption of dark meat fish, canned tuna, shellfish, and white meat fish individually. We divided the study time into three periods. The preadvisory period ran from April 1999 through December 2000. The advisory was published in January 2001. We allowed a 3-month “wash-in” period, January–March 2001, because dietary questionnaires asked about consumption up to 3 months before
Results
Table 1 presents characteristics of the 2235 participants who completed dietary questionnaires before and after the fish consumption advisory. There were 1300 subjects who completed all three dietary surveys, 365 who completed two, and 570 who completed one only. Subjects returned a total of 5200 semiquantitative food frequency questionnaires—approximately 88% completion for the first-trimester questionnaire, 72% for the second, and 90% for the third—of which 555 were completed during the
Discussion
The January 2001 federal advisory recommended that pregnant women avoid consuming predatory fish likely to contain high levels of mercury, including dark meat fish such as mackerel and swordfish.5 It also advised limiting consumption of shellfish, canned tuna, and smaller ocean fish to two to three servings per week.5
Pregnant women in this cohort consumed diminishing amounts of total fish after media attention to the adverse health effects of mercury exposure. Intake of canned tuna, dark meat
References (34)
- et al.
Cognitive deficit in 7-year-old children with prenatal exposure to methylmercury
Neurotoxicol Teratol
(1997) - et al.
The essentiality of long chain n-3 fatty acids in relation to development and function of the brain and retina
Prog Lipid Res
(2001) - et al.
Effects of prenatal and postnatal methylmercury exposure from fish consumption on neurodevelopmentOutcomes at 66 months of age in the Seychelles Child Development Study
JAMA
(1998) Toxicological effects of methylmercury
(2000)- Environmental Protection Agency. National advice on mercury in fish caught by family and friends: For women who are...
- Food and Drug Administration. Consumer advisory: An important message for pregnant women and women of childbearing age...
F.D.A. warns women not to eat some fish
New York Times
(2001)Warning sounded on safety of seafood
Boston Globe
(2001)Pregnant women warned not to eat shark, swordfish, mackerel
Washington Post
(2001)Do your pregnant patients know about the dangers of eating fish?
ACOG Today
(2001)
Mercury and methylmercury exposure in the New Jersey pregnant population
Arch Environ Health
Low consumption of seafood in early pregnancy as a risk factor for preterm deliveryProspective cohort study
BMJ
Frequency of seafood intake in pregnancy as a determinant of birth weightEvidence for a dose dependent relationship
J Epidemiol Community Health
The role of n-3 fatty acids in visual and cognitive developmentCurrent evidence and methods of assessment
J Pediatr
Fish and omega-3 fatty acid intake and risk of coronary heart disease in women
JAMA
Effect of government and commercial warnings on reducing prescription misuseThe case of propoxyphene
Am J Public Health
Quasi-experimentation: Design and analysis issues for field settings
Cited by (0)
- ☆
Supported by research grants from the National Institutes of Health (HD 34568, HL 64925, HL 68041) and by Harvard Medical School and the Harvard Pilgrim Health Care Foundation.
The authors thank Stephen Soumerai, ScD, who provided guidance in performing time series analysis, experience regarding investigations of behavior change following health advisories, and helpful comments on the manuscript.