Background: The association between coffee/tea intake and hypertensive disorders of pregnancy (HDP) remains unclear. This study aimed to investigate the association of caffeine, coffee, and tea intake during pregnancy with the risk of HDP. Methods: We assessed this association in 85,533 singleton pregnant women with live births in the Japan Environment and Children’s Study, a prospective cohort in Japan that included women from early pregnancy onward. Caffeinated and decaffeinated coffee and tea (green, oolong, and black) consumption during pregnancy was assessed using a validated food frequency questionnaire conducted at mid-pregnancy, and caffeine intake was calculated based on coffee and tea consumption. Multivariable logistic regression was used to assess the association with the risk of HDP. Results: HDP developed in 2222 women (2.6%). Caffeine intake was weakly associated with increased risk of HDP; the multivariable odds ratio of HDP for the highest versus the lowest quartile was 1.26 (95% confidence interval: 1.11, 1.43). Coffee drinkers of two or more cups per day showed a decreased risk compared with non-drinkers (multivariable odds ratio 0.79; 0.62, 0.99) even after adjustment for total caffeine intake. Tea consumption was not associated with the risk of HDP. Conclusions: Our study suggests that higher caffeine intake may increase HDP risk, while coffee drinkers had a lower risk. Further high-quality studies are needed to replicate these findings, and to elucidate if other substances in coffee may be protective against HDP.

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The association of chocolate consumption with risk of gestational diabetes has not been examined. We aimed to investigate the prospective association between chocolate consumption and risk of gestational diabetes in a large birth cohort in Japan. A total of 97 454 pregnant women with a median gestational age of 12 weeks were recruited from January 2011 to March 2014. Data on demographic information, disease history, socio-economic status, lifestyle and dietary habits were obtained at the study enrolment. Dietary intake during the past 12 months before study enrolment was assessed through a semi-quantitative FFQ. The logistic regression was used to obtain the OR of gestational diabetes in relation to chocolate consumption. Among 84 948 women eligible for the analysis, 1904 cases of gestational diabetes (2·2 %) were identified during the period of pregnancy. After controlling for potential confounding factors including age, smoking status, drinking status, education level, occupation, pre-pregnant BMI, depression, previous history of macrosomia babies, parity, physical activity and dietary factors, women in the highest quartile of chocolate consumption, compared with those in the lowest quartile, had a significantly lower risk of developing gestational diabetes (OR 0·78, 95 % CI 0·67, 0·90; P for trend = 0·002). Stratified analyses suggested that the association was not significantly modified by pre-pregnancy BMI, age, parity, smoking status or drinking status. The present prospective cohort study provided evidence that chocolate consumption was associated with a significant lower risk of gestational diabetes in Japanese women.

Background There is little evidence linking breakfast skipping to the incidence of gestational diabetes mellitus (GDM). Objectives We aimed to evaluate the prospective association of breakfast consumption with the incidence of GDM. Methods A total of 103,099 pregnancies were registered during study enrollment (January 2011 to March 2014), involving 97,454 pregnant women from 15 areas across Japan. Singleton pregnant women free of GDM, stroke, heart disease, cancer, and type 1 or type 2 diabetes at the study enrollment were eligible for analysis. We used a self-administered questionnaire to obtain data on demographic information, socioeconomic status, self-rated health status, disease history, lifestyle, and dietary habits of each woman at study enrollment. A semiquantitative FFQ was used for dietary assessment. We used logistic regression to obtain the OR of GDM in relation to breakfast consumption. Results Among 84,669 pregnant women for analysis, 1935 cases of GDM were documented. After adjustment for potential confounding factors including prepregnancy BMI, the multivariable-adjusted ORs of GDM for women who consumed breakfast 5–6 times/wk, 3–4 times/wk, and 0–2 times/wk were 1.09 (95% CI: 0.93, 1.27), 1.14 (95% CI: 0.96, 1.34), and 1.21 (95% CI: 1.05, 1.41), respectively, compared with daily breakfast eaters. The association appeared to be dose dependent (P-trend = 0.006) and was not significantly modified by prepregnancy BMI. Conclusions Breakfast consumption <3 times/wk before and during early pregnancy, compared with daily consumption, was associated with an increased odds of developing GDM.