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BMC Medicine
Published in: BMC Medicine 1/2013

Open Access 01-12-2013 | Research article

Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study

Authors: Verena Sengpiel, Elisabeth Elind, Jonas Bacelis, Staffan Nilsson, Jakob Grove, Ronny Myhre, Margaretha Haugen, Helle Margrete Meltzer, Jan Alexander, Bo Jacobsson, Anne-Lise Brantsæter

Published in: BMC Medicine | Issue 1/2013

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Abstract

Background

Pregnant women consume caffeine daily. The aim of this study was to examine the association between maternal caffeine intake from different sources and (a) gestational length, particularly the risk for spontaneous preterm delivery (PTD), and (b) birth weight (BW) and the baby being small for gestational age (SGA).

Methods

This study is based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. A total of 59,123 women with uncomplicated pregnancies giving birth to a live singleton were identified. Caffeine intake from different sources was self-reported at gestational weeks 17, 22 and 30. Spontaneous PTD was defined as spontaneous onset of delivery between 22+0 and 36+6 weeks (n = 1,451). As there is no consensus, SGA was defined according to ultrasound-based (Marsal, n = 856), population-based (Skjaerven, n = 4,503) and customized (Gardosi, n = 4,733) growth curves.

Results

The main caffeine source was coffee, but tea and chocolate were the main sources in women with low caffeine intake. Median pre-pregnancy caffeine intake was 126 mg/day (IQR 40 to 254), 44 mg/day (13 to 104) at gestational week 17 and 62 mg/day (21 to 130) at gestational week 30. Coffee caffeine, but not caffeine from other sources, was associated with prolonged gestation (8 h/100 mg/day, P <10-7). Neither total nor coffee caffeine was associated with spontaneous PTD risk. Caffeine intake from different sources, measured repeatedly during pregnancy, was associated with lower BW (Marsal-28 g, Skjaerven-25 g, Gardosi-21 g per 100 mg/day additional total caffeine for a baby with expected BW 3,600 g, P <10-25). Caffeine intake of 200 to 300 mg/day increased the odds for SGA (OR Marsal 1.62, Skjaerven 1.44, Gardosi 1.27, P <0.05), compared to 0 to 50 mg/day.

Conclusions

Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with spontaneous PTD risk. Caffeine intake was consistently associated with decreased BW and increased odds of SGA. The association was strengthened by concordant results for caffeine sources, time of survey and different SGA definitions. This might have clinical implications as even caffeine consumption below the recommended maximum (200 mg/day in the Nordic countries and USA, 300 mg/day according to the World Health Organization (WHO)) was associated with increased risk for SGA.
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Literature
1.
2.
Whincup PH, Kaye SJ, Owen CG, Huxley R, Cook DG, Anazawa S, Barrett-Connor E, Bhargava SK, Birgisdottir BE, Carlsson S, de Rooij SR, Dyck RF, Eriksson JG, Falkner B, Fall C, Forsen T, Grill V, Gudnason V, Hulman S, Hypponen E, Jeffreys M, Lawlor DA, Leon DA, Minami J, Mishra G, Osmond C, Power C, Rich-Edwards JW, Roseboom TJ, Sachdev HS, et al: Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008, 300: 2886-2897.CrossRefPubMed
3.
Roseboom TJ, Painter RC, van Abeelen AF, Veenendaal MV, de Rooij SR: Hungry in the womb: what are the consequences? Lessons from the Dutch famine. Maturitas. 2011, 70: 141-145. 10.1016/j.maturitas.2011.06.017.CrossRefPubMed
4.
Oesterheld JR: A review of developmental aspects of cytochrome P450. J Child Adolesc Psychopharmacol. 1998, 8: 161-174. 10.1089/cap.1998.8.161.CrossRefPubMed
5.
Andersson H, Hallström H, Kihlman BA: Intake of caffeine and other methylxanthines during pregnancy and risk for adverse effects in pregnant women and their foetuses. 2004, Copenhagen, Denmark: Nordic Council of Ministers, 2004.
6.
Wilkinson JM, Pollard I: Accumulation of theophylline, theobromine and paraxanthine in the fetal rat brain following a single oral dose of caffeine. Brain Res Dev Brain Res. 1993, 75: 193-199. 10.1016/0165-3806(93)90023-4.CrossRefPubMed
7.
Aldridge A, Bailey J, Neims AH: The disposition of caffeine during and after pregnancy. Semin Perinatol. 1981, 5: 310-314.PubMed
8.
World Health Organization: The world health report 2002. Reducing Risks, Promoting Healthy Life. 2002, Geneva, Switzerland: World Health Organization
9.
ACOG CommitteeOpinion No. 462: Moderate caffeine consumption during pregnancy. Obstet Gynecol. 2010, 116: 467-468. 10.1097/AOG.0b013e3181eeb2a1.CrossRef
10.
NNR Project group: Nordic nutrition recommendations 2004, Integrating nutrition and physical activity. 2004, Copenhagen, Denmark: Nordic Council of Ministers, Nord 2004 (13): 4
11.
12.
Bech BH, Nohr EA, Vaeth M, Henriksen TB, Olsen J: Coffee and fetal death: a cohort study with prospective data. Am J Epidemiol. 2005, 162: 983-990. 10.1093/aje/kwi317.CrossRefPubMed
13.
Cnattingius S, Signorello LB, Anneren G, Clausson B, Ekbom A, Ljunger E, Blot WJ, McLaughlin JK, Petersson G, Rane A, Granath F: Caffeine intake and the risk of first-trimester spontaneous abortion. N Engl J Med. 2000, 343: 1839-1845. 10.1056/NEJM200012213432503.CrossRefPubMed
14.
Fenster L, Eskenazi B, Windham GC, Swan SH: Caffeine consumption during pregnancy and fetal growth. Am J Public Health. 1991, 81: 458-461. 10.2105/AJPH.81.4.458.CrossRefPubMedPubMedCentral
15.
Giannelli M, Doyle P, Roman E, Pelerin M, Hermon C: The effect of caffeine consumption and nausea on the risk of miscarriage. Paediatr Perinat Epidemiol. 2003, 17: 316-323. 10.1046/j.1365-3016.2003.00523.x.CrossRefPubMed
16.
Infante-Rivard C, Fernandez A, Gauthier R, David M, Rivard GE: Fetal loss associated with caffeine intake before and during pregnancy. JAMA. 1993, 270: 2940-2943. 10.1001/jama.1993.03510240052031.CrossRefPubMed
17.
Mills JL, Holmes LB, Aarons JH, Simpson JL, Brown ZA, Jovanovic-Peterson LG, Conley MR, Graubard BI, Knopp RH, Metzger BE: Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation. JAMA. 1993, 269: 593-597. 10.1001/jama.1993.03500050071028.CrossRefPubMed
18.
Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M: Effects of caffeine on human health. Food Addit Contam. 2003, 20: 1-30.CrossRefPubMed
19.
Parazzini F, Chiaffarino F, Chatenoud L, Tozzi L, Cipriani S, Chiantera V, Fedele L: Maternal coffee drinking in pregnancy and risk of small for gestational age birth. Eur J Clin Nutr. 2005, 59: 299-301. 10.1038/sj.ejcn.1602052.CrossRefPubMed
20.
Peck JD, Leviton A, Cowan LD: A review of the epidemiologic evidence concerning the reproductive health effects of caffeine consumption: a 2000-2009 update. Food Chem Toxicol. 2010, 48: 2549-2576. 10.1016/j.fct.2010.06.019.CrossRefPubMed
21.
Rasch V: Cigarette, alcohol, and caffeine consumption: risk factors for spontaneous abortion. Acta Obstet Gynecol Scand. 2003, 82: 182-188. 10.1034/j.1600-0412.2003.00078.x.CrossRefPubMed
22.
Tolstrup JS, Kjaer SK, Munk C, Madsen LB, Ottesen B, Bergholt T, Gronbaek M: Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?. Hum Reprod. 2003, 18: 2704-2710. 10.1093/humrep/deg480.CrossRefPubMed
23.
Wen W, Shu XO, Jacobs DR, Brown JE: The associations of maternal caffeine consumption and nausea with spontaneous abortion. Epidemiology. 2001, 12: 38-42. 10.1097/00001648-200101000-00008.CrossRefPubMed
24.
Savitz DA, Hertz-Picciotto I, Poole C, Olshan AF: Epidemiologic measures of the course and outcome of pregnancy. Epidemiol Rev. 2002, 24: 91-101. 10.1093/epirev/mxf006.CrossRefPubMed
25.
Saigal S, Doyle LW: An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008, 371: 261-269. 10.1016/S0140-6736(08)60136-1.CrossRefPubMed
26.
Moster D, Lie RT, Markestad T: Long-term medical and social consequences of preterm birth. N Engl J Med. 2008, 359: 262-273. 10.1056/NEJMoa0706475.CrossRefPubMed
27.
Pallotto EK, Kilbride HW: Perinatal outcome and later implications of intrauterine growth restriction. Clin Obstet Gynecol. 2006, 49: 257-269. 10.1097/00003081-200606000-00008.CrossRefPubMed
28.
Magnus P, Irgens LM, Haug K, Nystad W, Skjaerven R, Stoltenberg C: Cohort profile: the Norwegian Mother and Child Cohort Study (MoBa). Int J Epidemiol. 2006, 35: 1146-1150. 10.1093/ije/dyl170.CrossRefPubMed
29.
Klonoff-Cohen H, Bleha J, Lam-Kruglick P: A prospective study of the effects of female and male caffeine consumption on the reproductive endpoints of IVF and gamete intra-Fallopian transfer. Hum Reprod. 2002, 17: 1746-1754. 10.1093/humrep/17.7.1746.CrossRefPubMed
30.
Mikkelsen TB, Osterdal ML, Knudsen VK, Haugen M, Meltzer HM, Bakketeig L, Olsen SF: Association between a Mediterranean-type diet and risk of preterm birth among Danish women: a prospective cohort study. Acta Obstet Gynecol Scand. 2008, 87: 325-330. 10.1080/00016340801899347.CrossRefPubMed
31.
Maslova E, Bhattacharya S, Lin SW, Michels KB: Caffeine consumption during pregnancy and risk of preterm birth: a meta-analysis. Am J Clin Nutr. 92: 1120-1132.
32.
Pennell CE, Jacobsson B, Williams SM, Buus RM, Muglia LJ, Dolan SM, Morken NH, Ozcelik H, Lye SJ, Relton C: Genetic epidemiologic studies of preterm birth: guidelines for research. Am J Obstet Gynecol. 2007, 196: 107-118. 10.1016/j.ajog.2006.03.109.CrossRefPubMed
33.
34.
Irgens LM: The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand. 2000, 79: 435-439. 10.1080/j.1600-0412.2000.079006435.x.CrossRefPubMed
35.
Meltzer HM, Brantsaeter AL, Ydersbond TA, Alexander J, Haugen M: Methodological challenges when monitoring the diet of pregnant women in a large study: experiences from the Norwegian Mother and Child Cohort Study (MoBa). Matern Child Nutr. 2008, 4: 14-27.CrossRefPubMed
36.
Marsal K, Persson PH, Larsen T, Lilja H, Selbing A, Sultan B: Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr. 1996, 85: 843-848. 10.1111/j.1651-2227.1996.tb14164.x.CrossRefPubMed
37.
Skjaerven R, Gjessing HK, Bakketeig LS: Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand. 2000, 79: 440-449. 10.1080/j.1600-0412.2000.079006440.x.CrossRefPubMed
38.
Gardosi J, Chang A, Kalyan B, Sahota D, Symonds EM: Customised antenatal growth charts. Lancet. 1992, 339: 283-287. 10.1016/0140-6736(92)91342-6.CrossRefPubMed
39.
40.
41.
42.
Brantsaeter AL, Haugen M, Rasmussen SE, Alexander J, Samuelsen SO, Meltzer HM: Urine flavonoids and plasma carotenoids in the validation of fruit, vegetable and tea intake during pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Public Health Nutr. 2007, 10: 838-847.CrossRefPubMed
43.
Brantsaeter AL, Haugen M, Alexander J, Meltzer HM: Validity of a new food frequency questionnaire for pregnant women in the Norwegian Mother and Child Cohort Study (MoBa). Matern Child Nutr. 2008, 4: 28-43.CrossRefPubMed
44.
Womack CJ, Saunders MJ, Bechtel MK, Bolton DJ, Martin M, Luden ND, Dunham W, Hancock M: The influence of a CYP1A2 polymorphism on the ergogenic effects of caffeine. J Int Soc Sports Nutr. 2012, 9: 7-10.1186/1550-2783-9-7.CrossRefPubMedPubMedCentral
45.
CARE Study Group: Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. BMJ. 2008, 337: a2332.CrossRef
46.
Vidaeff AC, Ramin SM: Potential biochemical events associated with initiation of labor. Curr Med Chem. 2008, 15: 614-619. 10.2174/092986708783769786.CrossRefPubMed
47.
Moreira AS, Nunes FM, Domingues MR, Coimbra MA: Coffee melanoidins: structures, mechanisms of formation and potential health impacts. Food Funct. 2012, 3: 903-915. 10.1039/c2fo30048f.CrossRefPubMed
48.
Clausson B, Granath F, Ekbom A, Lundgren S, Nordmark A, Signorello LB, Cnattingius S: Effect of caffeine exposure during pregnancy on birth weight and gestational age. Am J Epidemiol. 2002, 155: 429-436. 10.1093/aje/155.5.429.CrossRefPubMed
49.
Klebanoff MA, Levine RJ, Clemens JD, Wilkins DG: Maternal serum caffeine metabolites and small-for-gestational age birth. Am J Epidemiol. 2002, 155: 32-37. 10.1093/aje/155.1.32.CrossRefPubMed
50.
Bracken MB, Triche EW, Belanger K, Hellenbrand K, Leaderer BP: Association of maternal caffeine consumption with decrements in fetal growth. Am J Epidemiol. 2003, 157: 456-466. 10.1093/aje/kwf220.CrossRefPubMed
51.
Tough SC, Newburn-Cook CV, White DE, Fraser-Lee NJ, Faber AJ, Frick C, Svenson LW, Sauve R: Do maternal characteristics and past pregnancy experiences predict preterm delivery among women aged 20 to 34?. J Obstet Gynaecol Can. 2003, 25: 656-666.CrossRefPubMed
52.
Khoury JC, Miodovnik M, Buncher CR, Kalkwarf H, McElvy S, Khoury PR, Sibai B: Consequences of smoking and caffeine consumption during pregnancy in women with type 1 diabetes. J Matern Fetal Neonatal Med. 2004, 15: 44-50. 10.1080/14767050310001650716.CrossRefPubMed
53.
Santos IS, Matijasevich A, Valle NC: Mate drinking during pregnancy and risk of preterm and small for gestational age birth. J Nutr. 2005, 135: 1120-1123.PubMed
54.
Bech BH, Obel C, Henriksen TB, Olsen J: Effect of reducing caffeine intake on birth weight and length of gestation: randomised controlled trial. BMJ. 2007, 334: 409-10.1136/bmj.39062.520648.BE.CrossRefPubMedPubMedCentral
55.
Haugen M, Meltzer HM, Brantsaeter AL, Mikkelsen T, Osterdal ML, Alexander J, Olsen SF, Bakketeig L: Mediterranean-type diet and risk of preterm birth among women in the Norwegian Mother and Child Cohort Study (MoBa): a prospective cohort study. Acta Obstet Gynecol Scand. 2008, 87: 319-324. 10.1080/00016340801899123.CrossRefPubMed
56.
Kirkinen P, Jouppila P, Koivula A, Vuori J, Puukka M: The effect of caffeine on placental and fetal blood flow in human pregnancy. Am J Obstet Gynecol. 1983, 147: 939-942.CrossRefPubMed
57.
Weathersbee PS, Lodge JR: Caffeine: its direct and indirect influence on reproduction. J Reprod Med. 1977, 19: 55-63.PubMed
58.
Lawson CC, LeMasters GK, Levin LS, Liu JH: Pregnancy hormone metabolite patterns, pregnancy symptoms, and coffee consumption. Am J Epidemiol. 2002, 156: 428-437. 10.1093/aje/kwf035.CrossRefPubMed
59.
Grosso LM, Rosenberg KD, Belanger K, Saftlas AF, Leaderer B, Bracken MB: Maternal caffeine intake and intrauterine growth retardation. Epidemiology. 2001, 12: 447-455. 10.1097/00001648-200107000-00015.CrossRefPubMed
60.
Orskou J, Henriksen TB, Kesmodel U, Secher NJ: Maternal characteristics and lifestyle factors and the risk of delivering high birth weight infants. Obstet Gynecol. 2003, 102: 115-120. 10.1016/S0029-7844(03)00402-2.PubMed
61.
Vik T, Bakketeig LS, Trygg KU, Lund-Larsen K, Jacobsen G: High caffeine consumption in the third trimester of pregnancy: gender-specific effects on fetal growth. Paediatr Perinat Epidemiol. 2003, 17: 324-331. 10.1046/j.1365-3016.2003.00507.x.CrossRefPubMed
62.
Grosso LM, Triche EW, Belanger K, Benowitz NL, Holford TR, Bracken MB: Caffeine metabolites in umbilical cord blood, cytochrome P-450 1A2 activity, and intrauterine growth restriction. Am J Epidemiol. 2006, 163: 1035-1041. 10.1093/aje/kwj125.CrossRefPubMed
63.
Infante-Rivard C: Caffeine intake and small-for-gestational-age birth: modifying effects of xenobiotic-metabolising genes and smoking. Paediatr Perinat Epidemiol. 2007, 21: 300-309. 10.1111/j.1365-3016.2007.00825.x.CrossRefPubMed
64.
Hernandez-Diaz S, Schisterman EF, Hernan MA: The birth weight "paradox" uncovered?. Am J Epidemiol. 2006, 164: 1115-1120. 10.1093/aje/kwj275.CrossRefPubMed
65.
Nilsen RM, Vollset SE, Gjessing HK, Skjaerven R, Melve KK, Schreuder P, Alsaker ER, Haug K, Daltveit AK, Magnus P: Self-selection and bias in a large prospective pregnancy cohort in Norway. Paediatr Perinat Epidemiol. 2009, 23: 597-608. 10.1111/j.1365-3016.2009.01062.x.CrossRefPubMed
66.
Svilaas A, Sakhi AK, Andersen LF, Svilaas T, Strom EC, Jacobs DR, Ose L, Blomhoff R: Intakes of antioxidants in coffee, wine, and vegetables are correlated with plasma carotenoids in humans. J Nutr. 2004, 134: 562-567.PubMed
67.
Kvalvik LG, Nilsen RM, Skjaerven R, Vollset SE, Midttun O, Ueland PM, Haug K: Self-reported smoking status and plasma cotinine concentrations among pregnant women in the Norwegian Mother and Child Cohort Study. Pediatr Res. 2012, 72: 101-107. 10.1038/pr.2012.36.CrossRefPubMedPubMedCentral
Metadata
Title
Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study
Authors
Verena Sengpiel
Elisabeth Elind
Jonas Bacelis
Staffan Nilsson
Jakob Grove
Ronny Myhre
Margaretha Haugen
Helle Margrete Meltzer
Jan Alexander
Bo Jacobsson
Anne-Lise Brantsæter
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2013
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-11-42

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