Seafood Intake During Pregnancy and Lactation and Child Neurocognitive Development: A NESR Systematic Review

Abstract

Objectives: To inform the Dietary Guidelines for Americans, 2020-2025, the USDA and HHS identified important public health questions to be examined by the 2020 Dietary Guidelines Advisory Committee. The Committee conducted a systematic review with support from USDA's Nutrition Evidence Systematic Review (NESR) team to answer the question: What is the relationship between seafood consumption during pregnancy and lactation and neurocognitive development in the child? Methods: The Committee developed a protocol that described how they would use NESR's systematic review methodology to examine evidence related to seafood intake during pregnancy and lactation and child neurocognitive development. NESR librarians conducted a literature search (2000-2019) and NESR analysts dual-screened the results using pre-defined inclusion and exclusion criteria. NESR analysts extracted data and assessed risk of bias of included studies. The Committee synthesized the evidence, developed conclusion statements, and graded the strength of evidence underlying the conclusion statements. Results: Twenty-six articles (from 18 prospective cohort studies [PCS]) met inclusion criteria; all assessed prenatal seafood intake and none assessed seafood intake during lactation. Evidence from 15 PCS suggests that prenatal seafood intake has beneficial associations with cognitive development, particularly in young children. Evidence from 12 PCS suggests that there may be a beneficial association between prenatal seafood intake and language/communication development. Less consistent evidence and/or scant to no evidence was available for movement/physical or social-emotional/behavioral development, attention-deficit/hyperactivity disorder, autism, academic performance, anxiety, and depression. Conclusions: Moderate evidence indicates that seafood intake during pregnancy is associated favorably with measures of cognitive development in young children. Limited evidence suggests that seafood intake during pregnancy may be associated favorably with measures of language and communication development in the child. Insufficient or no evidence was available for all other relationships assessed.