Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications

Abstract

IMPORTANCEWomen are recommended to limit caffeine consumption to less than 200 mg per day based on risks to fetal health. Impacts of caffeine on maternal health remain unclear. OBJECTIVE To determine whether caffeinated-beverage intake and plasma caffeine and paraxanthine are associated with cardiometabolic complications in pregnancy (ie, gestational diabetes [GDM], preeclampsia, and gestational hypertension [GH]). DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from a longitudinal pregnancy cohort study from the National Institute of Child Health and Human Development (NICHD) FetalGrowth Studies-Singletons (2009-2013. This post hoc secondary analysis of 2802 pregnant women without major chronic conditions enrolled at 12 US clinical sites was completed in 2021. The final sample for caffeinated beverage analyses included 2583 women. After excluding women who did not consent to have their biospecimens stored for future research (n = 54), plasma caffeine analyses included 2529 women. Analyses of caffeine consumption and fasting cardiometabolic profiles included 319 women. EXPOSURES Daily total caffeine intake was estimated at 10 to 13 gestational weeks and 16 to 22 gestational weeks based on self-reported past week intake of caffeinated coffee, tea, soda, and energy drinks. Plasma caffeine and paraxanthine were measured in specimens collected at 10 to 13 weeks. MAIN OUTCOMES AND MEASURESClinical diagnoses of GDM, preeclampsia, GH, glucose concentrations from GDM screening, and blood pressure were extracted from medical records. RESULTSParticipants had a mean (SD) age of 28.1 (5.5) years and 422 participants (16.3%) were Asian/Pacific Islander women, 741 (28.9%) were Hispanic women, 717 (27.8%) were non-Hispanic Black women, and 703 (27.2%) were non-Hispanic White women. At 10 to 13 weeks, 1073 women (41.5%) reported consuming no caffeinated beverages, 1317 (51.0%) reported consuming 1 mg/d to 100 mg/d, 173 (6.7%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d. At 16 to 22 weeks, 599 women (23.6%) reported consuming no caffeinated beverages, 1734 (68.3%) reported consuming 1 mg/d to 100 mg/d, 186 (7.3%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d caffeinated beverages. Intake at 16 to 22 weeks was associated with lower GDM risk and lower glucose concentrations (1 mg/d to 100 mg/d vs none: relative risk, 0.53 [95% CI, 0.35 to 0.80]; β, -2.7 mg/dL [95% CI, -5.4 mg/dL to 0 mg/dL]) and lower C-reactive protein and C-peptide concentrations and favorable lipid profiles. Total plasma caffeine and paraxanthine at 10 to 13 weeks was inversely associated with glucose (quartile 4 vs quartile 1: β = -3.8 mg/dL [95% CI, -7.0 mg/dL to -0.5 mg/dL]; trend of P = .01). No associations were observed with preeclampsia or GH.

The association between caffeine exposure during pregnancy and risk of gestational hypertension/preeclampsia: A meta‐analysis and systematical review

“…[38][39][40][41] Therefore, one possible explanation for our results is the low caffeine intake of pregnant women in the included studies, leading to a lower proportion of pregnant women consuming moderate to high doses. 16,17,42 Although, as stated above, our results do not allow to draw a conclusion about causality, it is reasonable to speculate about possible mechanisms for the putative adverse effects of coffee or soft drink consumption on preeclampsia. Coffee contains several compounds such as kahweol, cafestol, chlorogenic acid, and trigonelline.…”

“…Pregnant women have been shown to signi cantly reduce their caffeine intake, especially coffee during pregnancy (37)(38)(39)(40). Therefore, one possible explanation for our results is the low caffeine intake of pregnant women in the included studies, leading to a lower proportion of pregnant women consuming moderate to high doses (14,15,41).…”

“…An initial search from various electronic databases found 701 relevant studies. After excluding unrelated papers, 10 studies eventually met the inclusion criteria (14)(15)(16)(18)(19)(20)(21)(22)(23)(24). The basic characteristics of selected studies are described in Table 1.…”

“…Nevertheless, observational studies on caffeine intake during pregnancy and the risk of GH/preeclampsia have yielded mixed results. Some papers displayed no relationship between caffeine intake during pregnancy and the risk of GH/preeclampsia 16,17 . Conversely, a nationwide birth cohort study by Kawanishi et al 18 reported that high dose of caffeine intake during pregnancy could increase the risk of GH/preeclampsia.…”

The therapeutic potential of matcha tea: A critical review on human and animal studies

“…In addition, in vivo research showed that caffeine antagonizes adenosine receptor, which leads to higher release of epinephrine and therefore, enhanced insulin sensitivity ( Thong and Graham, 2002 ). Similarly, evidence from a recent cohort of pregnant women reported that caffeine intake reduced the risk for gestational diabetes mellitus (GDM) by decreasing blood glucose, C-reactive protein and C-peptide levels, and resulted in favorable lipid profiles ( Hinkle et al, 2021 ). Theanine consumption has also been shown to lower blood pressure ( Deka and Vita, 2011 ; Yoto et al, 2012 ) and reduce inflammation ( Sergi et al, 2017 ) both of which relate to a lower risk for cardio-metabolic diseases.…”