Relationship between maternal caffeine and coffee intake and pregnancy loss: A grading of recommendations assessment, development, and evaluation-assessed, dose-response meta-analysis of observational studies

Abstract

BackgroundNumerous studies report an association between coffee or caffeine consumption and pregnancy loss; however, the nature and strength of this relationship have not been clearly established. Based on recent studies, our meta-analysis aimed to test whether a dose–response relationship between coffee or caffeine consumption and pregnancy loss exists.MethodsWe searched for articles in PubMed, Web of Science, and Scopus published until May 2022. Two independent reviewers extracted data and rated the quality of the evidence using the GRADE approach. We applied a random-effects, one-stage dose–response meta-analysis.ResultsA total of 34 articles (18 cohort studies and 16 case-control studies) were included in this review. Results showed a significantly higher risk of pregnancy loss for coffee consumption before (Pooled ES: 1.21; 95% CI: 1.01–1.43) and during pregnancy (Pooled ES: 1.26; 95% CI: 1.04–1.57), and for coffee consumption during pregnancy in case-control studies (Pooled ES: 1.20; 95% CI: 1.19–6.41). Findings from this meta-analysis demonstrated that caffeine intake during pregnancy was associated with a significantly higher risk of pregnancy loss in cohort (Pooled ES: 1.58; 95% CI: 1.23–2.01) and case-control studies (Pooled ES: 2.39; 95% CI: 1.69–3.37, P < 0.001), respectively. A dose–response analysis suggested that an increase of a cup of coffee per day during pregnancy was associated with 3% increased risk of pregnancy loss; 100 mg of caffeine per day during pregnancy was also associated with 14 and 26% increased risk of pregnancy loss in cohort and case-control studies, respectively. A non-linear dose–response association was observed between coffee intake and the risk of pregnancy loss.ConclusionThis study confirms that coffee or caffeine consumption raises the risk of pregnancy loss. Researchers are encouraged to conduct more studies to explore the underlying mechanisms and active compounds in coffee and caffeine.Systematic Review Registration[www.crd.york.ac.uk/prospero/], identifier [CRD42021267731].

Evaluation of Recurrent Pregnancy Loss

“…Therefore, patients should limit their caffeine intake to less than 300 mg/d and consider further limitation to less than 99 mg/d. 117,[119][120][121][122][123]…”

Instituto de pesquisa café e saúde: Prevenção de doenças e melhora da qualidade de vida

“…Estes benefícios têm de ser ponderados em função de alguns potenciais riscos associados ao consumo de café, como ansiedade, insônia, cefaleias, tremor e palpitações, sintomas que surgem mais frequentemente como consequência de um consumo de doses mais elevadas de café (O' Keefe et al, 2018;Poole et al, 2017) e muitas vezes resultantes de outros fatores associados ao consumo de café (consumo de tabaco, álcool). Também, mulheres gestantes deverão ter em conta o possível impacto do café no desenvolvimento fetal (Jafari et al, 2022;Williford et al, 2023), nos partos prematuros (L. W. Chen et al, 2016;Greenwood et al, 2014;Z. X. Li et al, 2016;Rhee et al, 2015) e aborto espontâneo (Jafari et al, 2022;Lyngsø et al, 2017) , assim como as questões em aberto sobre o impacto do consumo de café na osteoporose e fraturas associadas (Hallstrom et al, 2013;Johansson et al, 1992;Kiel et al, 1990).…”

“…Também, mulheres gestantes deverão ter em conta o possível impacto do café no desenvolvimento fetal (Jafari et al, 2022;Williford et al, 2023), nos partos prematuros (L. W. Chen et al, 2016;Greenwood et al, 2014;Z. X. Li et al, 2016;Rhee et al, 2015) e aborto espontâneo (Jafari et al, 2022;Lyngsø et al, 2017) , assim como as questões em aberto sobre o impacto do consumo de café na osteoporose e fraturas associadas (Hallstrom et al, 2013;Johansson et al, 1992;Kiel et al, 1990).…”

Placental biomarkers of fetal-originated diseases

“…The adverse environment during pregnancy can be divided into exogenous factors and maternal factors. It has been found that most of the adverse environmental factors can cross the placental barrier and directly affect embryonic or fetal development, such as polycyclic aromatic hydrocarbons, [4] particulate matter 2.5 (PM2.5), [5,6] dexamethasone, [7,8] heavy metals, [9,10] nicotine, [11,12] ethanol, [13] caffeine, [14,15] cocaine, [16,17] and opioids, [17][18][19] etc. Besides, some environmental factors that cannot cross the placental barrier can indirectly affect fetal development by disrupting the structure and function of the placenta, such as exposure to cobalt and chromium nanoparticles causing placental autophagic flow impairment and interleukin (IL)-6 release, which disrupts fetal astrocytes and neurons development.…”