Oken · American journal of epidemiology 2008 · prospective cohort study · n=341 mother-child pairs

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

Cited 423 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective cohort study

PubMed 18353804 · doi:10.1093/aje/kwn034 · record verified 2026-08-29

What was done

Authors analyzed a prospective cohort of 341 mother-child pairs in Massachusetts enrolled between 1999 and 2002. They assessed maternal second-trimester fish intake and erythrocyte mercury concentrations. Child cognitive development was tested at age 3 years using the Peabody Picture Vocabulary Test (PPVT) and the Wide Range Assessment of Visual Motor Abilities (WRAVMA). Multivariable linear regression was used to evaluate associations with mutual adjustment for fish intake and mercury exposure.

What was found

Mean maternal fish intake was 1.5 (standard deviation, 1.4) servings/week, and 40 mothers (12%) consumed >2 servings/week. Mean maternal mercury was 3.8 (standard deviation, 3.8) ng/g. In mutually adjusted models, fish intake >2 servings/week versus never showed an effect estimate of 2.2 (95% CI: -2.6, 7.0) on the PPVT and 6.4 (95% CI: 2.0, 10.8) on the WRAVMA; intake of <=2 servings/week showed no benefit. Mercury in the top decile was associated with lower scores on both the PPVT (-4.5, 95% CI: -8.5, -0.4) and the WRAVMA (-4.6, 95% CI: -8.3, -0.9).

Why it matters

The findings demonstrate opposing influences of maternal seafood consumption during pregnancy, showing that nutritional benefits for child cognition coexist with negative impacts from mercury exposure.

Limits

The study is observational and prone to residual confounding. The sample of women consuming >2 servings of fish per week was small (n = 40). Exposure was assessed only in the second trimester, and results from a single regional cohort may not generalize to populations with different seafood diets or contamination levels.

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