Abstract
BackgroundPregnant 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).MethodsThis 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.ResultsThe 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.ConclusionsCoffee, 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.
Highlights
Black tea, soft drinks and chocolate accounted for more than 98% of daily caffeine intake but, interestingly, the dominant source differed in the low-intake and high-intake groups, with chocolate dominating in the first quintile, black tea in the second and third quintiles and coffee in the upper quintiles (Figure 2)
Caffeine intake related to maternal characteristics is presented in Table 2: older, unmarried and smoking women with higher parity, history of preterm delivery (PTD), lower pre-pregnancy body mass index (BMI), less nausea, higher energy intake and higher household income had significantly higher caffeine intake
Coffee intake is associated with slightly increased gestational length but does not affect the odds for spontaneous PTD
Summary
There is increasing epidemiological evidence that maternal nutrition influences the course of pregnancy as well as fetal growth and development and the risk of disease later in life [1,2,3]. Caffeine is a xanthine alkaloid found primarily in coffee, tea, cocoa, energy drinks and some soft drinks, and is consumed on a daily basis all over the world. The current World Health Organization (WHO) guidelines recommend a caffeine intake below 300 mg/day during pregnancy [8], while the American College of Obstetricians and Gynecologists and the Norwegian Food Safety Authority concur with the Nordic Nutrition Recommendations (NNR), recommending a maximum caffeine intake of 200 mg/day [9,10,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
