Background: Environmental exposures, including dietary contaminants, may influence the developing immune system. Aims: This study assesses effects of maternal seafood consumption during pregnancy on the occurrence of wheezing and allergy in preschool children. Both fish and shellfish were studied since they differ according to their fatty acid (ω 3) content with antiallergic properties, and their concentration of allergenic pollutants or toxins. Methods: The PELAGIE cohort included 3421 women recruited at the beginning of pregnancy. Maternal fish and shellfish intake was measured at inclusion by a food frequency questionnaire. Wheezing and allergy (atopic dermatitis and food allergy) were evaluated by questionnaire to the mother when the child was 2 years old (n = 1505). Estimation of the association between seafood intake and outcomes took into account major confounders like familial history of asthma and/or allergy, sex, pre-term birth, small-for-gestational-age, maternal age, parity, smoking during pregnancy, postnatal parental smoking at home, daycare attendance, breastfeeding. Results: Moderate maternal fish intake during pregnancy (1 to 4 times a month) was associated with a lower risk of wheezing (OR=0.64 [0.42-0.98]) before age two compared to low intake (＜once/month). Shellfish consumption of at least once a month was associated with a higher risk of food allergy before age 2 (OR=1.57 [1.06-2.32]) compared to non or weak consumers (＜once/month). Discussion/Conclusion: These results suggest that different categories of seafood may be differently associated with respiratory and allergic outcomes. In agreement with the literature, a moderate maternal fish intake appears negatively linked with wheezing. This study suggests for the first time that prenatal exposure to shellfish contaminants may increase the risk of food allergy.
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