Association between self-reported caffeine intake during pregnancy and social responsiveness scores in childhood: The EARLI and HOME studies.

Marisa A Patti,Margaret Daniele Fallin,Lisa A Croen,Kristen Lyall,Aimin Chen,Melissa Eliot,Irva Hertz-Picciotto,Joseph M Braun,Nan Li,Jane Khoury,Craig Newschaffer,Bruce P Lanphear,Kimberly Yolton,Jaymie Meliker

doi:10.1371/journal.pone.0245079

Abstract

Maternal nutrition during gestation has been investigated for its role in child neurodevelopment. However, little is known about the potential impact of gestational caffeine exposure on child autistic behaviors. Here, we assess the relation between maternal caffeine intake during pregnancy and children’s behavioral traits related to Autism Spectrum Disorder (ASD). We harmonized data from two pregnancy cohorts, Early Autism Risk Longitudinal Investigation (EARLI) (n = 120), an enriched-risk cohort of mothers who previously had a child with ASD, from Pennsylvania, Maryland, and Northern California (2009–2012), and the Health Outcomes and Measures of the Environment (HOME) Study (n = 269), a general population cohort from Cincinnati, Ohio (2003–2006). Mothers self-reported caffeine intake twice during pregnancy. Caregivers reported child behavioral traits related to ASD using the Social Responsiveness Scale (SRS) when children were aged 3–8 years. Higher scores indicate more ASD-related behaviors. We estimated covariate-adjusted differences in continuous SRS T-scores per interquartile range increase in caffeine intake. Self-reported caffeine intake during pregnancy was positively associated with SRS T-scores among children in EARLI (β: 2.0; 95% CI -0.1, 4.0), but to a lesser extent in HOME (β: 0.6; 95% CI -0.5, 1.6). In HOME, pre-pregnancy body mass index (BMI) modified the association between caffeine intake and SRS T-scores, where more positive associations were observed among women with higher BMIs. Our findings suggest gestational caffeine intake may represent a marker of vulnerability to childhood ASD-related behaviors. Additional studies are warranted to extend these findings.

Highlights

Maternal nutrition during pregnancy has been associated with child health
We speculate that differences in the magnitude of the associations in the Early Autism Risk Longitudinal Investigation (EARLI) and Health Outcomes and Measures of the Environment (HOME) studies could be due to differences between genetic loading and how this may modify the impact of environmental risk factors
In EARLI, and to a lesser extent in HOME, higher maternal caffeine intake during pregnancy was associated with modest increases in Autism Spectrum Disorder (ASD)-related behaviors among 3–8 year old children

Summary

Introduction

Folate, iron, mercury, omega-3 fatty acids, and caffeine have been implicated in the etiology of child neurodevelopment [1,2,3,4,5,6]. The long-term effect of maternal caffeine consumption on neurodevelopment remains inconclusive with most previous epidemiologic studies focusing on outcomes relating to Attention Deficit Hyperactivity Disorder (ADHD) and intelligence (IQ). Several cohort studies have identified associations of gestational caffeine intake with increased child hyperactivity [14, 15] and decreased IQ [16], but not others [17,18,19,20]. Findings using rat models identified adverse effects of caffeine intake during gestation on offspring cognition and social behaviors [21,22,23,24,25,26]

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