Fish consumption may be beneficial for a developing human fetus, but fish may also contain contaminants that could be detrimental. Great Lakes sport-caught fish (GLSCF) are contaminated with polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethylene (DDE), but the effects of these contaminants on birth outcome are not clear. To distinguish potential contaminant effects, we examined (1) whether the decrease over time in contaminant levels in GLSCF is paralleled by an increase in birth weight of children of GLSCF-consuming mothers and (2) the relation between maternal serum concentrations of these contaminants and birth weight. Mothers (n=511) were interviewed from 1993 to 1995, and maternal serum was collected from 1994 to 1995 (n=143). Potential confounders considered were child gender, maternal age at delivery, maternal prepregnancy body mass index, maternal cigarette and alcohol use during pregnancy, maternal education level, maternal parity, and maternal breastfeeding. Children born during 1970-1977, 1978-1984, and 1985-1993 to mothers who ate more than 116 meals of GLSCF before pregnancy were, on average, 164 g lighter, 46 g heavier, and 134 g heavier, respectively, than children of mothers who ate no GLSCF before pregnancy (P trend=0.05). GLSCF-consuming mothers had higher serum PCB and DDE concentrations, but only increased DDE was associated with lower birth weight. The data suggest that fetal DDE exposure (as indicated by maternal serum DDE concentration) may decrease birth weight and that decreased birth weight effects associated with GLSCF consumption have decreased over time.