Abstract
BackgroundMaternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA). SGA babies are known to be at increased risk for adverse neonatal outcomes. The aim of this study was to explore the associations between prenatal caffeine exposure and neonatal health.MethodsThe study is based on 67,569 full-term singleton mother-infant pairs from the Norwegian Mother and Child Cohort Study. Caffeine consumption from different sources was self-reported in gestational week 22. Neonatal compound outcomes, namely (1) morbidity/mortality and (2) neonatal intervention, were created based on the Medical Birth Registry of Norway. Adjusted logistic regression was performed.ResultsCaffeine exposure was associated to SGA (OR = 1.16, 95%CI: 1.10; 1.23) and being born SGA was significantly associated with neonatal health (OR = 3.09, 95%CI: 2.54; 3.78 for morbidity/mortality; OR = 3.94, 95%CI: 3.50; 4.45 for intervention). However, prenatal caffeine exposure was neither associated with neonatal morbidity/mortality (OR = 1.01, 95%CI: 0.96; 1.07) nor neonatal intervention (OR = 1.02, 95%CI: 1.00; 1.05 for a 100 mg caffeine intake increase). Results did not change after additional adjustment for SGA status.ConclusionsModerate prenatal caffeine exposure (< 200 mg/day) does not seem to impair neonatal health, although prenatal caffeine exposure is associated with the child being born SGA and SGA with neonatal health. We suggest diversity in neonatal outcomes of SGA infants according to the underlying cause of low birth weight.
Highlights
Maternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA)
Our group published a significant association between prenatal caffeine exposure and reduced birth weight as well as increased risk of a baby being small for gestational age (SGA) (odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.10, 1.26) based on 59,123 women from the Norwegian Mother and Child Cohort Study (MoBa) [8]
SGA is strongly associated with neonatal morbidity and mortality [17], and SGA infants are more often admitted to Neonatal Intensive Care Units (NICUs) [18]
Summary
Maternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA). The aim of this study was to explore the associations between prenatal caffeine exposure and neonatal health. Our group published a significant association between prenatal caffeine exposure and reduced birth weight as well as increased risk of a baby being small for gestational age (SGA) (odds ratio (OR) = 1.18, 95% confidence interval (CI): 1.10, 1.26) based on 59,123 women from the Norwegian Mother and Child Cohort Study (MoBa) [8]. Depending on the underlying cause of reduced birth weight, the risk of neonatal morbidity and mortality might differ. Different underlying SGA causes have been suggested as an explanation for the so-called “birth weight paradox” – neonates born SGA by smokers have a lower infant mortality than neonates born SGA by non-smokers. Hernandez-Diaz proposed that neonates born SGA due to other - more severe SGA causes than smoking such as e.g. congenital malformation have a higher neonatal death risk [19]
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