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Seafood Toxicant Exposure During Pregnancy, Lactation, and Childhood and Child Outcomes: A Scoping Review

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This scoping review examines how toxins found in seafood, including contaminants that can accumulate on microplastics, affect child growth and development during pregnancy, breastfeeding, and early childhood. The review identified which toxin-outcome pairs have enough evidence for deeper analysis. The findings highlight the importance of understanding how environmental contaminants in our food supply may affect children's health.

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Objectives: To inform the National Academies of Science, Engineering, and Medicine (NASEM) committee on the role of seafood in child growth and development, this scoping review was conducted to describe the evidence associated with seafood toxicants and child outcomes and determine which toxicant and outcome pairs have sufficient evidence to conduct systematic reviews. Methods: This review included interventions and prospective cohort studies examining seafood toxicant exposure during childhood (0-18 years) or pregnancy and lactation from countries with a high or very high Human Development Index and child developmental outcomes. Studies had to measure seafood and toxicant exposure, analyzing the link with each other or their associations with the outcome. Records were dual-screened at the title, abstract, and full-text levels. Results: A total of 73 articles were included; 62 articles on exposure during pregnancy and lactation and 13 articles in children. Number of studies varied by toxicant and exposure population (maternal vs child): polychlorinated biphenyls (PCB; n=11 vs 1), dioxin-like compounds (n=3 vs 0), polybrominated diphenyl ethers (n=3 vs 1), per- and polyfluoroalkyl substances (n=7 vs 2), arsenic (n=4 vs 4), cadmium (n=4 vs 4), lead (n=9 vs 3), selenium (n=11 vs 1), iron (n=2 vs 1), magnesium (n=1 vs 1), zinc (n=3 vs 2), and dichlorodiphenyltrichloroethane (n=5 vs 1). No studies were included for polycyclic aromatic hydrocarbons, iodine, aldrin, dieldrin, chlordane, chlorpyrifos, and microplastics exposures. Outcomes varied by exposure population (maternal vs child): exposure biomarkers (n=21 vs 4), neurodevelopmental (n=30 vs 9), growth-related (n=16 vs 1), cardiometabolic, (n=3 vs 2), immune-related (n=1 vs 2), chronic disease-related (n=2 vs 0), and other adverse events (n=5 vs 0). Only 2 exposure-outcomes pairs had 3 or more studies and were considered sufficient to conduct a systematic review: PCB exposure during pregnancy and lactation on child growth and Pb exposure during pregnancy and lactation on child development. Conclusions: Overall, there is a lack of evidence on seafood toxicant exposures and child health outcomes. There is sufficient evidence to conduct systematic reviews on PCBs and child growth and on Pb and developmental outcomes. Funding Sources: NASEM.

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