Heavy Maternal Fish Consumption andDevelopmental Milestones - A Cross-Sectional Study

Background: Fish is a healthy addition to the diet. It’s vitamin, mineral and nutrient content and it’s protective effects on the cardiovascular system are common knowledge today. But are there conditions when excessive fish consumption can lead to negative effects on health? Studies have been, and are being conducted on the adverse effects of fish consumption, especially in children born to pregnant mothers whose diet consists predominantly of fish. Greater mercury levels in fish exposed to toxic substances in the sea have been under study as one of the components in fish that can cause adverse effects. We selected the village of Rehri Goth, located at the coastal areas of Pakistan, and home to a fishermen community where fishing is the primary means of livelihood for a large majority of the population and fish is the staple food in the community.Objectives: To determine the impact of fish on the developmental milestones of children born to mothers consuming fish regularly during pregnancy and while breastfeeding.Methodology: A questionnaire based, cross-sectional study with a sample of 244 mothers and a total of 352 indexed children. The study was conducted at a community centre and in the community at Rehri Goth, Karachi, throughout March-May 2009. In the community centre, mothers with their children present prior to seeing the primary care doctor were requested to participate in the study. Door-to-door interviews were also conducted in the community at large. Mothers were explained objectives of the study and written consent was taken. Only mothers with children under 5 years of age were included in the study. Age (in months) of achieving certain milestones was documented and compared with standard ranges of developmental milestones for Pakistani children. The milestones were divided into several categories: gross motor, fine motor and speech development. Results: Out of a total of 244 mothers, 220 consumed fish daily during pregnancy and breastfeeding, a percentage of 90.1%. The mean age at beginning to walk was 11.1 months (S.D- 2.1) for male children and 10.9 (S.D- 2.3) for females. The mean age at first words was 11.2(S.D- 2.4) for males and 11.0 (S.D- 2.2) for females. The data was compared to the mean age of children achieving these milestones from other studies across Pakistan as well as normal ranges and it was found after adjustments for covariates that there is no significant link between greater consumption of fish during pregnancy and breast feeding with delay in developmental milestones in children. Conclusion: The study found no signif