Committee Opinion No. 462: Moderate Caffeine Consumption During Pregnancy

doi:10.1097/aog.0b013e3181eeb2a1

Cited by 111 publications

(34 citation statements)

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“…The idea that prenatal caffeine exposure is associated with low birth weight and leads to other adverse effects is not accepted by all 53, 63 . However, prenatal caffeine exposure is concerning enough that Nordic countries and the United States recommend that pregnant women limit their caffeine intake to less than 200 mg per day 64, 65 .…”

Section: Caffeinementioning

confidence: 99%

Long-term consequences of disrupting adenosine signaling during embryonic development

Rivkees

Wendler

2017

Molecular Aspects of Medicine

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There is growing evidence that disruption in the prenatal environment can have long-lasting effects on an individual’s health in adulthood. Research on the fetal programming of adult diseases, including cardiovascular disease, focuses on epi-mutations, which alter the normal pattern of epigenetic factors such as DNA methylation, miRNA expression, or chromatin modification, rather than traditional genetic alteration. Thus, understanding how in utero chemical exposures alter epigenetics and lead to adult disease is of considerable public health concern. Few signaling molecules have the potential to influence the developing mammal as the nucleoside adenosine. Adenosine levels increase rapidly with tissue hypoxia and inflammation. Adenosine antagonists including the methlyxanthines caffeine and theophylline are widely consumed during pregnancy. The receptors that transduce adenosine action are the A1, A2a, A2b, and A3 adenosine receptors (ARs). We examined the long-term effects of in utero disruption of adenosine signaling on cardiac gene expression, morphology, and function in adult offspring. One substance that fetuses are frequently exposed to is caffeine, which is a non-selective adenosine receptor antagonist. Over the past several years, we examined the role of adenosine signaling during embryogenesis and cardiac development. We discovered that in utero alteration in adenosine action leads to adverse effects on embryonic and adult murine hearts. We find that cardiac A1ARs protect the embryo from in utero hypoxic stress, a condition that causes an increase in adenosine levels. After birth in mice, we observed that in utero caffeine exposure leads to abnormal cardiac function and morphology in adults, including an impaired response to β-adrenergic stimulation. Recently, we observed that in utero caffeine exposure induces transgenerational effects on cardiac morphology, function, and gene expression. Our findings indicate that the effects of altered adenosine signaling are dependent on signaling through the A1ARs and timing of disruption. In addition, the long-term effects of altered adenosine signaling appear to be mediated by alterations in DNA methylation, an epigenetic process critical for normal development.

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Section: Caffeinementioning

confidence: 99%

Long-term consequences of disrupting adenosine signaling during embryonic development

Rivkees

Wendler

2017

Molecular Aspects of Medicine

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“…Based on these results, caffeine restriction during pregnancy is encouraged in many national guidelines, but the large variety in cutoff values (0-300mg caffeine) underlines the inconsistency of current evidence. [30–34]…”

Section: Introductionmentioning

confidence: 99%

Antenatal coffee and tea consumption and the effect on birth outcome and hypertensive pregnancy disorders

et al. 2017

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Background and objectiveCoffee and tea are commonly consumed during pregnancy. While several of their components, like caffeine, have strong pharmacological effects, the effect on the unborn fetus remains unclear. Caffeine intake has been associated with abortion, preterm birth and fetal growth restriction, but a general consensus on caffeine restriction is still lacking. We aimed to investigate antenatal coffee, tea and caffeine consumption and the effect on birth weight and length, gestational age at birth and hypertensive disorders in pregnancy.MethodsA total of 936 healthy pregnancies from the WHISTLER birth cohort with data on coffee and tea consumption were included. Maternal and child characteristics as well as antenatal coffee and tea consumption were obtained through postpartum questionnaires. Reported consumption was validated using available preconceptional data. Caffeine intake was calculated from coffee and tea consumption. Linear and logistic regression was used to assess the association with birth outcome and hypertensive disorders.ResultsAfter adjustment for smoking and maternal age, a daily consumption of more than 300mg of caffeine compared to less than 100mg of caffeine was significantly associated with an increased gestational age (linear regression coefficient = 2.00 days, 95%CI = 0.12–4.21, P = 0.03). Tea consumption was significantly related to a higher risk of pregnancy induced hypertension (OR = 1.13, 95%CI = 1.04–1.23, P = 0.004). No associations concerning coffee consumption or birth weight and birth length were observed.ConclusionsDaily caffeine consumption of more than 300mg is possibly associated with an increase in gestational age at birth. A possible relation between high tea consumption and increased risk for pregnancy induced hypertension warrants further research. For most outcomes, we found no significant associations with coffee or tea intake.

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“…Although some studies have not found an association between maternal consumption of high levels of caffeine and delivering a small for gestational age and/or low birth weight infant [9–20], other studies have noted an association [21–32], and when further risk factors are taken into account such as maternal tobacco smoking and alcohol consumption, the association remains [23, 27, 28]. While a 2010 review released by the American College of Obstetricians and Gynecologists noted that the relationship between maternal caffeine consumption and fetal growth restriction is still undetermined [33], recent findings from two large European cohort studies point to compelling evidence for an increase in fetal growth restriction associated with increasing levels of caffeine intake, particularly for mothers consuming 200+ mg of caffeine per day during pregnancy [27, 28]. While current recommendations suggest limiting caffeine intake to 200 mg/day (approximately one and a half to two cups of fresh coffee) during pregnancy [34], the threshold of caffeine exposure has still not been well established, and a better understanding of the association between caffeine and fetal growth, especially in varying amounts and in the presence of a range of other maternal exposures, remains an important area of maternal and child health research.…”

Section: Introductionmentioning

confidence: 99%

Maternal Caffeine Consumption and Small for Gestational Age Births: Results from a Population-Based Case–Control Study

Hoyt

Browne

Richardson

et al. 2013

Matern Child Health J

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Caffeine is consumed in various forms during pregnancy, has increased half-life during pregnancy and crosses the placental barrier. Small for gestational age (SGA) is an important perinatal outcome and has been associated with long term complications. We examined the association between maternal caffeine intake and SGA using National Birth Defects Prevention Study data. Non-malformed live born infants with an estimated date of delivery from 1997–2007 (n = 7,943) were included in this analysis. Maternal caffeine exposure was examined as total caffeine intake and individual caffeinated beverage type (coffee, tea, and soda); sex-, race/ethnic-, and parity-specific growth curves were constructed to estimate SGA births. Crude and adjusted odds ratios (aORs) and 95 % confidence intervals were estimated using unconditional logistic regression. Interaction with caffeine exposures was assessed for maternal smoking, vasoconstrictor medication use, and folic acid. Six hundred forty-eight infants (8.2 %) were found to be SGA in this analysis. Increasing aORs were observed for increasing intakes of total caffeine and for each caffeinated beverage with aORs (adjusting for maternal education, high blood pressure, and smoking) ranging from 1.3 to 2.1 for the highest intake categories (300+ mg/day total caffeine and 3+ servings/day for each beverage type). Little indication of additive interaction by maternal smoking, vasoconstrictor medication use, or folic acid intake was observed. We observed an increase in SGA births for mothers with higher caffeine intake, particularly for those consuming 300+ mg of caffeine per day. Increased aORs were also observed for tea intake but were more attenuated for coffee and soda intake.

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Committee Opinion No. 462: Moderate Caffeine Consumption During Pregnancy

Cited by 111 publications

References 0 publications

Long-term consequences of disrupting adenosine signaling during embryonic development

Long-term consequences of disrupting adenosine signaling during embryonic development

Antenatal coffee and tea consumption and the effect on birth outcome and hypertensive pregnancy disorders

Maternal Caffeine Consumption and Small for Gestational Age Births: Results from a Population-Based Case–Control Study

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