June 10, 2014
(Reaffirmed November 2015)
Washington, DC — The American College of Obstetricians and Gynecologists is currently reviewing the Food and Drug Administration’s (FDA) proposed update to its advice on seafood consumption during pregnancy. ACOG supported previous FDA and Environmental Protection Agency (EPA) recommendations, reflecting them within the 2013 Committee Opinion on Exposure to Toxic Environmental Agents, which recommended that obstetricians encourage their pregnant patients to consume up to 12 ounces a week of fish and shellfish that are low in mercury.
Since the FDA and the EPA issued their last joint advisory in 2004, further information has become available that suggests that consumption of low-mercury seafood can be particularly beneficial during pregnancy, with benefits including improved neurodevelopmental outcomes. FDA and EPA report that pregnant women currently consume below this level.
Because of this, ACOG encourages women to follow the updated FDA recommendations that pregnant women, women who might become pregnant, and breastfeeding mothers should eat at least 8 and up to 12 ounces per week of a variety of fish lower in mercury. This can provide the benefits of seafood consumption without increasing any related risk to women or their babies. They should continue to avoid fish with the highest mercury concentrations, specifically tilefish, shark, swordfish, and king mackerel. They should continue to limit consumption of white (albacore) tuna to 6 ounces a week.
As the leading health care organization dedicated to the health of women and their families, ACOG is committed to ensuring that its practice recommendations are guided by science. To that end, ACOG will continue to review the FDA’s proposed recommendations and data sources as well as any emerging scientific and clinical data prior to updating or re-issuing any clinical guidelines. In the meantime, ACOG suggests that women discuss with their physicians, including their obstetrician-gynecologists, the new positive FDA advisory of the potential benefits of seafood consumption, while keeping in mind the 12 ounce per week limit in order to avoid the harmful effects of mercury.
To learn more about what led the FDA to update its recommendations, read this post from the agency's acting chief scientist: Why We Want Pregnant Women and Children to Eat More Fish.
A Practice Advisory is issued when information on an emergent clinical issue (e.g. clinical study, scientific report, draft regulation) is released that requires an immediate or rapid response, particularly if it is anticipated that it will generate a multitude of inquiries. A Practice Advisory is a brief, focused statement issued within 24-48 hours of the release of this evolving information and constitutes ACOG clinical guidance. A Practice Advisory is issued only on-line for Fellows but may also be used by patients and the media. Practice Advisories are reviewed periodically for reaffirmation, revision, withdrawal or incorporation into other ACOG guidelines.
This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.
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The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org