Caffeine Intake throughout Pregnancy, and Factors Associated with Non-Compliance with Recommendations: A Cohort Study

Abstract

Maternal caffeine consumption is associated with adverse gestational outcomes. The aim of this study was to assess the intake of caffeine and factors associated with the non-adherence to caffeine intake recommendations in a cohort of 463 women before (T0) and in each trimester of gestation (T1, T2, and T3), by using validated questionnaires. Caffeine intake (median (mg/day), IQR) was 100.0 (181.1) at T0, 9.42 (66.2) at T1, 12.5 (65.6) at T2, and 14.0 (61.1) at T3 (p < 0.001). Non-compliance prevalence (intake > 200 mg/day) was 6.2% at T1, 4.2% at T2, and 2.7% at T3. Not being an active smoker at T1 (OR = 0.17; 95% CI 0.05–0.59) and T2 (OR = 0.22; 95% CI 0.09–0.52), adherence to the Mediterranean Diet at T1 (OR = 0.50; 95% CI 0.28–0.88) and T2 (OR = 0.39; 95% CI 0.15–1.02), and moderate physical activity at T1 (OR = 0.50; 95% CI 0.28–0.88) were inversely associated with caffeine consumption. Although caffeine intake may be considered low, intake prevalence increases throughout pregnancy. Although the main source of caffeine during pregnancy is coffee, attention must be also paid to the increasingly intake of chocolate, of which the effect during pregnancy is controversial. Smoking, non-adherence to a good quality diet, and light physical activity are associated with a higher caffeine intake and a lower compliance with caffeine intake recommendations. Perinatal dietary and lifestyle educational policies are needed.

Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show?

“…However, this ′safe′ dosage is being reevaluated based on increasing evidence, which has shown that even daily doses of less than 300 mg may increase the risk of pregnancy failure. Furthermore, other studies found that even a daily intake as low as 100–200 mg during pregnancy is associated with an increased risk of miscarriage, fetal growth restriction, low birth weight, as well as increased risks to the offspring, including cognitive development impairments, overweight, and obesity [ 182 ]. These studies raise concern that there may be no absolute safe threshold of caffeine consumption during pregnancy.…”