Caffeine intake during pregnancy, late miscarriage and stillbirth

Abstract

Caffeine is a commonly consumed drug during pregnancy with the potential to affect the developing fetus. Findings from previous studies have shown inconsistent results. We recruited a cohort of 2643 pregnant women, aged 18-45 years, attending two UK maternity units between 8-12 weeks gestation from September 2003 to June 2006. We used a validated tool to assess caffeine intake at different stages of pregnancy and related this to late miscarriage and stillbirth, adjusting for confounders, including salivary cotinine as a biomarker of smoking status. There was a strong association between caffeine intake in the first trimester and subsequent late miscarriage and stillbirth, adjusting for confounders. Women whose pregnancies resulted in late miscarriage or stillbirth had higher caffeine intakes (geometric mean = 145 mg/day; 95% CI: 85 to 249) than those with live births (103 mg/day; 95% CI: 98 to 108). Compared to those consuming <100 mg/day, odds ratios increased to 2.2 (95% CI: 0.7 to 7.1) for 100-199 mg/day, 1.7 (0.4 to 7.1) for 200-299 mg/day, and 5.1 (1.6 to 16.4) for 300+ mg/day (P trend =0.004). Greater caffeine intake is associated with increases in late miscarriage and stillbirth. Despite remaining uncertainty in the strength of association, our study strengthens the observational evidence base on which current guidance is founded.

Maternal caffeine intake during pregnancy and risk of pregnancy loss: a categorical and dose–response meta-analysis of prospective studies

“…Thus, residual confounding by smoking may still be a concern due to under-reporting of smoking in pregnant women. Nevertheless, in Greenwood et al's study higher maternal caffeine intake was associated with a higher risk of late miscarriage and stillbirth even after adjustment for salivary cotinine, a biomarker for smoking (47) . Pregnancy symptoms including nausea, vomiting, and aversions to smells and taste are more common in healthy pregnancies than in pregnancies that end in spontaneous abortion (17) .…”

“…1. We included fourteen prospective studies (12,23,26,36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47) on caffeine intake and pregnancy loss involving 130 456 participants and 3429 cases of pregnancy loss (Table 1). One of the studies (38) was included for only qualitative review because it did not report data for more than two categories of caffeine intake.…”

The Generation R Study: design and cohort update 2012

“…The major pregnancy outcomes, including live births, induced abortion fetal or perinatal loss, pregnancy induced hypertension, preeclampsia, and gestational diabetes are known in 99% of all enrolled mothers. These outcomes are related to various exposures of interest [132][133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148]. In all children known to be born alive, information about sex, birth weight and gestational age is available.…”

The testis of the mice C57/BL6 offspring in adulthood have alterations due to maternal caffeine consumption

“…The majority of the world's population including pregnant women uses substantial amounts of caffeine on a regular basis 5,6 . The most commonly known sources of caffeine are coffee, cocoa beans, kola nuts, and tea leaves, but at least 63 plant species worldwide present compounds known as methylxanthines like caffeine (1, 3, 7-trimethylxanthine) 7 .…”