Maternal Caffeine Consumption Research Articles

The effect of maternal caffeine consumption during the perinatal period on lactation

Background: Caffeine is a substance found in various seeds, foods, beverages and pharmaceuticals. We sought to assess perinatal caffeine consumption rates and the impact of maternal consumption on lactation. Material and Method: This is a prospective, descriptive cohort study conducted in Greece. Women were recruited from five tertiary maternity hospitals throughout 2020. A total of 847 mothers participated and data were collected during their hospitalization in the maternity hospital using a structured questionnaire. Follow-up included a telephone interview in the first, third and sixth month after delivery. Results: A significant decrease in caffeine consumption was reported during pregnancy (84.7%) compared to the period before pregnancy (96.3%, p<0.001). On the fourth day postpartum, caffeine intake (65.8%) was reduced significantly compared to the pre-pregnancy period (p<0.001), remaining relatively unchanged over a period of three months postpartum (1st month: 71%, 3rd month: 64.7%). Moreover, there was a significant decline in caffeine intake at six months postpartum (54.2%, p<0.001) and after discontinuation of breastfeeding (42.7%, p<0.001). Our findings showed that women who ceased breastfeeding at any stage over the six-month follow-up consumed less caffeine during the first three months after delivery (p<0.001) in comparison to those who maintained breastfeeding at six months. In addition, higher pre-pregnancy caffeine consumption (β = 0.04, SE: 0.02, p = 0.032) had a positive association with longer breastfeeding duration. Conclusions: Τhis study was the first to record caffeine intake in the perinatal period in the Greek setting. The results demonstrate that perinatal maternal caffeine consumption was reduced compared to the pre-pregnancy period and that there was a positive correlation between caffeine consumption and breastfeeding duration.

Maternal Caffeine Consumption during Gestation and Lactation Abolishes Cortical Oxidative Stress and Restores Na+/K+-ATPase Activity in Neonates Exposed to Hyperthermia-Induced Seizures.

Caffeine is a psychoactive substance that is widely consumed by individuals of various demographics, including pregnant women. It can readily cross the blood-brain and placental barriers, easily reaching the fetal brain. In addition, caffeine has also shown antioxidant properties, as its consumption reduces oxidative stress in various pathologies, including epilepsy. Febrile seizures (FS) are among the most common convulsive disorders in infants and young children. Here, we used an animal model of FS to learn whether maternal caffeine (1 g/L) intake consumption during gestation and lactation could exert beneficial effects on the rat cortex. Neonatal development was analyzed by measuring pinna opening, eye opening, righting reflex on the surface, and geotaxis reflex. Five and twenty days after HIS, the rats were euthanized, and plasma membranes and cytosolic fractions were isolated from their cortex brain. The enzymatic activities of glutathione reductase, glutathione S-transferase, Na+/K+-ATPase, and Mg2+-ATPase, as well as the levels of thiobarbituric acid reacting substances, were quantified. Results showed that maternal caffeine intake eliminates oxidative stress and normalizes Na+/K+-ATPase activity disrupted by HIS and also affects some parameters relating to the neurodevelopment of neonates. As FS in infants has been related to epilepsy in adults, the antioxidant properties of caffeine could prevent potential damage from hyperthermia.

Maternal Caffeine Consumption and Its Impact on the Fetus: A Review

Maternal Caffeine Consumption and Its Impact on the Fetus: A Review

Maternal caffeine consumption during pregnancy and offspring cord blood DNA methylation: an epigenome-wide association study meta-analysis.

Background: Prenatal caffeine exposure may influence offspring health via DNA methylation, but no large studies have tested this. Materials & methods: Epigenome-wide association studies and differentially methylated regions in cord blood (450k or EPIC Illumina arrays) were meta-analyzed across sixEuropean cohorts (n= 3725). Differential methylation related to self-reported caffeine intake (mg/day) from coffee, teaand cola was compared with assess whether caffeine is driving effects. Results: One CpG site (cg19370043, PRRX1) was associated with caffeine and another (cg14591243, STAG1) with cola intake. A total of12-22 differentially methylated regions were detected with limited overlap across caffeinated beverages. Conclusion: We found little evidence to support an intrauterine effect of caffeine on offspring DNA methylation. Statistical power limitations may have impacted our findings.

The Physiological, Cognitive, and Developmental Effects of Prenatal Caffeine Consumption on Foetal Pregnancy Outcomes

Introduction: Maternal caffeine consumption during pregnancy may confer developmental risk to the foetus due to caffeine’s ability to cross the blood brain barrier (BBB) and blood placental barrier (BPB). This literature review investigated caffeine’s properties and mechanism of passage through the BBB and BPB. The subsequent effects of moderate-to-excessive maternal caffeine consumption (≥ 200mg of caffeine daily) on physical development, cognition, and behaviour were further explored. Methods: The review was conducted using PubMED, NCBI, and Google Scholar, using key terms such as “pregnancy”, “caffeine”, “prenatal”, “adverse effect”, “development”, and “embryo development”. Articles selected were published within the last 15 years (2008-2023) and longitudinal studies, cohort studies, and experimental methods using animal models were included. Results: It was found prenatal caffeine exposure poses a variety of potential consequences for the infant prior to and after delivery. Notably, physical developmental risks include fetal growth restriction, birth defect(s), and changes in neuronal structure and blood flow. Cognitive and behavioural consequences include possible links to externalizing behaviour problems, decreased intelligence quotient (IQ), attentive deficit and hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) during childhood. Discussion: This research is primarily restricted to animal models and cohort studies. Moroever, there were several conflicting conclusions surrounding behavioural and cognitive effects of prenatal caffeine exposure. This drives inquiry into how further research can both solidify causal relationships and be conducted ethically to help inform parents about the potential risks of prenatal caffeine exposure. Conclusion: With a global trend of increasing caffeine consumption, through coffee, black tea, and recently, matcha, this review provided insight into this ever-growing aspect of our lifestyles. It is paramount to understand the effect of caffeine on foetuses to promote safe and healthy pregnancy outcomes.

Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece during the COVID-19 pandemic.

Low-level knowledge of problematic substance use during the perinatal period may lead to numerous adverse outcomes. We sought to determine maternal tobacco, alcohol and caffeine consumption during the perinatal period during the COVID-19 pandemic. This prospective cohort study recruited women from five Greek maternity hospitals between January and May 2020. Data were collected with a structured questionnaire initially completed by postpartum women during their hospitalization and re-administered via telephone interview in the first, third and sixth month postpartum. The study sample consisted of 283 women. Smoking rates decreased during pregnancy (12.4%) compared to the pre-pregnancy period (32.9%, p<0.001) and during lactation (5.6%) compared to the antenatal period (p<0.001). The smoking rate increased again after breastfeeding cessation (16.9%) compared to the rate during lactation (p<0.001), but remained lower than the pre-pregnancy rate (p=0.008). Only 1.4% of the women reported breastfeeding cessation due to smoking, whereas those who smoked more during pregnancy were more likely to cease breastfeeding (OR=1.24; 95% CI: 1.05-1.48, p=0.012). Regarding alcohol consumption, it was significantly lower during pregnancy (5.7%), lactation (5.5%) and after breastfeeding cessation (5.2%) compared to the pre-pregnancy period (21.9%, p<0.001 for all correlations). Women who consumed alcohol during lactation were less likely to wean (OR=0.21; 95% CI: 0.05-0.83, p=0.027). Caffeine intake decreased during pregnancy compared to preconception period (p<0.001), while in lactating women it remained at low rates until the 3rd month of follow-up. Caffeine consumption at one month postpartum (β=0.09; SE=0.04, p=0.045) was positively associated with longer duration of breastfeeding. Tobacco, alcohol and caffeine consumption decreased in the perinatal period compared to the preconception period. The pandemic may have contributed to the downtrend in smoking and alcohol consumption due to COVID-related restrictions and fear of potential illness. Nevertheless, smoking was associated with reduced duration of breastfeeding and breastfeeding cessation.

Maternal dietary caffeine consumption and risk of birth defects in the National Birth Defects Prevention Study, 1997-2011.

Caffeine consumption is common during pregnancy, but published associations with birth defects are mixed. We updated estimates of associations between prepregnancy caffeine consumption and 48 specific birth defects from the National Birth Defects Prevention Study (NBDPS) for deliveries from 1997 to 2011. NBDPS was a large population-based case-control study conducted in 10 U.S. states. We categorized self-reported total dietary caffeine consumption (mg/day) from coffee, tea, soda, and chocolate as: <10, 10 to <100, 100 to <200, 200 to <300, and ≥ 300. We used logistic regression to estimate adjusted odds ratios (aORs [95% confidence intervals]). Analyses for defects with ≥5 exposed case children were adjusted for maternal race/ethnicity, age at delivery, body mass index, early pregnancy cigarette smoking and alcohol use, and study site. Our analysis included 30,285 case and 11,502 control children, with mothers of 52% and 54%, respectively, reporting consuming <100 mg caffeine, and 11% of mothers of both cases and controls reported consuming ≥300 mg per day. Low (10 to <100 mg/day) levels of prepregnancy caffeine consumption were associated with statistically significant increases in aORs (1.2-1.7) for 10 defects. Associations with high (≥300 mg/day) levels of caffeine were generally weaker, except for craniosynostosis and aortic stenosis (aORs=1.3 [1.1-1.6], 1.6 [1.1-2.3]). Given the large number of estimates generated, some of the statistically significant results may be due to chance and thus the weakly increased aORs should be interpreted cautiously. This study supports previous observations suggesting lack of evidence for meaningful associations between caffeine consumption and the studied birth defects.

Caffeine Intake throughout Pregnancy, and Factors Associated with Non-Compliance with Recommendations: A Cohort Study.

Maternal caffeine consumption is associated with adverse gestational outcomes. The aim of this study was to assess the intake of caffeine and factors associated with the non-adherence to caffeine intake recommendations in a cohort of 463 women before (T0) and in each trimester of gestation (T1, T2, and T3), by using validated questionnaires. Caffeine intake (median (mg/day), IQR) was 100.0 (181.1) at T0, 9.42 (66.2) at T1, 12.5 (65.6) at T2, and 14.0 (61.1) at T3 (p < 0.001). Non-compliance prevalence (intake > 200 mg/day) was 6.2% at T1, 4.2% at T2, and 2.7% at T3. Not being an active smoker at T1 (OR = 0.17; 95% CI 0.05−0.59) and T2 (OR = 0.22; 95% CI 0.09−0.52), adherence to the Mediterranean Diet at T1 (OR = 0.50; 95% CI 0.28−0.88) and T2 (OR = 0.39; 95% CI 0.15−1.02), and moderate physical activity at T1 (OR = 0.50; 95% CI 0.28−0.88) were inversely associated with caffeine consumption. Although caffeine intake may be considered low, intake prevalence increases throughout pregnancy. Although the main source of caffeine during pregnancy is coffee, attention must be also paid to the increasingly intake of chocolate, of which the effect during pregnancy is controversial. Smoking, non-adherence to a good quality diet, and light physical activity are associated with a higher caffeine intake and a lower compliance with caffeine intake recommendations. Perinatal dietary and lifestyle educational policies are needed.

Association of Maternal Caffeine Consumption During Pregnancy With Child Growth

Greater caffeine consumption in pregnancy is associated with reduced birth size, but potential associations with childhood growth are unclear. To evaluate the associations of pregnancy caffeine and paraxanthine measures with child growth in a contemporary cohort with low caffeine consumption and a historical cohort with high caffeine consumption. The Environmental Influences on Child Health Outcomes cohort of the National Institute of Child Health and Human Development Fetal Growth Studies (ECHO-FGS; 10 sites, 2009-2013) was a pregnancy cohort with 1 child measurement between ages 4 and 8 years (follow-up in 2017-2019). The Collaborative Perinatal Project (CPP) was a pregnancy cohort (12 sites, 1959-1965) with child follow-up through 8 years (1960-1974). The current secondary analysis was conducted in 2021 and 2022. Concentrations of caffeine and its primary metabolite, paraxanthine, were quantified from plasma (ECHO-FGS) and serum (CPP) collected in the first trimester. Cut points for analyses were defined by quartiles in ECHO-FGS and quintiles in CPP. Child z scores for body mass index, weight, and height were evaluated, as well as fat mass index and percentage and obesity risk measured at 1 time between age 4 and 8 years in ECHO-FGS. In a secondary analysis of the CPP cohort, child z scores and obesity risk longitudinally through age 8 years were evaluated. In ECHO-FGS (median caffeine intake <50 mg/d), 788 children (mean [SD] age, 6.8 [1.0] years; 411 boys [52.2%]) of women in the fourth vs first quartile of plasma caffeine concentrations had lower height z scores (β = -0.21; 95% CI, -0.41 to -0.02), but differences in weight z scores were only observed in the third quartile (β = -0.27; 95% CI, -0.47 to -0.07). In CPP, beginning at age 4 years, 1622 children (805 boys [49.7%]) of women in the highest caffeine quintile group had lower height z scores than their peers from the lowest group, with the gap widening with each successive year of age (β = -0.16 [95% CI, -0.31 to -0.01] at 4 years; β = -0.37 [95% CI, -0.57 to -0.16] at 8 years). There were slight reductions in weight at ages 5 to 8 years for children in the third vs first caffeine quintile (β = -0.16 to -0.22). Results were consistent for paraxanthine concentrations in both cohorts. Intrauterine exposure to increasing levels of caffeine and paraxanthine, even in low amounts, was associated with shorter stature in early childhood. The clinical implication of reductions in height and weight is unclear; however, the reductions were apparent even with levels of caffeine consumption below clinically recommended guidelines of less than 200 mg per day.

In nonsmoking pregnant patients, is maternal caffeine consumption associated with low birth weight?

In nonsmoking pregnant patients, is maternal caffeine consumption associated with low birth weight?

Maternal caffeine intake and DNA methylation in newborn cord blood

Epigenetic mechanisms may underlie associations between maternal caffeine consumption and adverse childhood metabolic outcomes. However, limited studies have examined neonate DNA methylation (DNAm) patterns in the context of preconception or prenatal exposure to caffeine metabolites. We examined preconception and pregnancy caffeine exposure with DNAm alterations in neonate cord blood (n=378). In a secondary analysis of the Effects of Aspirin in Gestation and Reproduction Trial (EAGeR), we measured maternal caffeine, paraxanthine, and theobromine concentrations from stored serum collected preconception (on average 2 months before pregnancy) and at 8 weeks of gestation. In parallel, self-reported caffeinated beverage intake was captured via administration of questionnaires and daily diaries. We profiled DNAm from the cord blood buffy coat of singletons using the MethylationEPIC BeadChip. We assessed associations of maternal caffeine exposure and methylation β values using multivariable robust linear regression. A false discovery rate (FDR) correction was applied using the Benjamini-Hochberg method. In preconception, the majority of women reported consuming 1 or fewer servings/day of caffeine on average, and caffeine and paraxanthine metabolite levels were 88 and 36µmol/L, respectively. Preconception serum caffeine metabolites were not associated with individual cytosine-guanine (CpG) sites (FDR>5%), though pregnancy theobromine was associated with DNAm at cg09460369 near RAB2A (β = 0.028; SE=0.005; FDR P=0.012). Preconception self-reported caffeinated beverage intake compared to no intake was associated with DNAm at cg09002832 near GLIS3 (β = -0.013; SE=0.002; FDR P=0.036). No associations with self-reported intake during pregnancy were found. Few effects of maternal caffeine exposure on neonate methylation differences in leukocytes were identified in this population with relatively low caffeine consumption.

The caffeine consumption among Turkish pregnant women.

Caffeine consumption during pregnancy has effect on newborn anthropometry therefore the amount of maternal caffeine consumption is important. This study aims to determine caffeine consumption during pregnancy and related factors. This study was carried out in a maternity hospital located in Eastern Turkey from September 2018 to June 2019 with 300 healthy primiparous women and babies. Data were collected by the researchers with a socio-demographic questionnaire and caffeine consumption frequency semi-quantitative questionnaire using the face-to-face interview technique. Postpartum weight and height of the women and length, weight, and head circumference of the newborns were measured. Evaluation of the data was carried out with Kruskal-Wallis and Mann-Whitney U test and binary logistic regression analysis was used for relationship analysis. The mean daily caffeine intake of the pregnant women was determined as 344.9 ± 181.4 mg/day and 4.9 ± 2.6 mg/kg/day. The babies' mean birth weight was 2943.1 ± 407.4 g, mean length was 50.1 ± 2.2 cm, and mean head circumference was 32.3 ± 1.6 cm. A statistically significant negative correlation was found between caffeine consumption of pregnant women and newborn birth weight and length (P = 0.049; P = 0.007, respectively). After age, economic and educational status, and pre- and post-pregnancy BMI were corrected according to weight increase during pregnancy and after binary logistic regression analysis was performed, it was determined that caffeine consumption did not have an effect on low birth weight (Total caffeine consumption (mg/day), P = 0.669 OR = 1.00, 95% Cl = 0.997-1.002; caffeine consumption (mg/kg), P = 0.549 OR = 0.956, 95% Cl = 0.824-1.109). Caffeine consumption of pregnant women is higher than the recommended levels. Therefore, pregnant women should be informed about caffeine sources and consumption amounts.

Maternal caffeine consumption and child growth in the ECHO cohort of NICHD Fetal Growth Studies

Greater caffeine consumption during pregnancy is associated with smaller infant birth size, but little is known about its association with growth in childhood. Previous studies have found measures of childhood adiposity and growth linked to maternal caffeine consumption, but all used inherently limited self-reported caffeine measures. We have previously demonstrated that higher maternal plasma concentrations of caffeine and paraxanthine were associated with smaller neonatal anthropometrics. We now investigate whether the association of smaller birth size with higher maternal caffeine measures persists into childhood.

Maternal caffeine consumption and childhood behavioural and neurocognitive development: A focused narrative review

Rationale: The majority of pregnant women regularly consume caffeine, a habit-forming substance of no nutritional value for mother or baby. Objectives: To examine evidence of association between maternal caffeine consumption and childhood behavioural and neurocognitive development, and to consider the soundness of current health guidance concerning the consumption of caffeine during pregnancy. Methods: Database searches identified a large pool of peer-reviewed articles, which when culled for relevance yielded a modest corpus of animal and human research for inclusion in this focussed narrative review of potential caffeine-related threats to childhood behavioural and neurocognitive development. Results: High biological plausibility of potential harm from maternal caffeine exposure indicated by early animal research is confirmed by more recent animal studies that sought to mimic human consumption patterns. Reported negative outcomes include increased neuronal network excitability and susceptibility to seizures in offspring, and disruptions to electrophysiological activity, learning, and memory. In contrast, human observational studies have yielded inconsistent findings. Some studies have reported evidence of negative behavioural and neurocognitive outcomes, including hyperkinetic disorder, attention deficit disorder, and intelligence level in preschool- and elementary-aged children. Other studies, however, reported no associations with maternal caffeine consumption for similar parameters. Conclusions: Current understanding of caffeine-related increased risk of harm for childhood development is limited due to inconsistent findings from human research. However, persistent reports of possible negative outcomes indicate high priority need for further research. In the meantime, the cumulative scientific evidence supports advice to pregnant women and women contemplating pregnancy to avoid caffeine.

Maternal and child genetic liability for smoking and caffeine consumption and child mental health: an intergenerational genetic risk score analysis in the ALSPAC cohort.

Background and aimsPrevious studies suggest an association between maternal tobacco and caffeine consumption during and outside of pregnancy and offspring mental health. We aimed to separate effects of the maternal environment (intrauterine or postnatal) from pleiotropic genetic effects.DesignSecondary analysis of a longitudinal study. We (i) validated smoking and caffeine genetic risk scores (GRS) derived from published genome‐wide association study (GWAS) for use during pregnancy, (ii) compared estimated effects of maternal and offspring GRS on childhood mental health outcomes and (iii) tested associations between maternal and offspring GRS on their respective outcomes.SettingWe used data from a longitudinal birth cohort study from England, the Avon Longitudinal Study of Parents and Children (ALSPAC).ParticipantsOur sample included 7921 mothers and 7964 offspring.MeasurementsMental health and non‐mental health phenotypes were derived from questionnaires and clinical assessments: 79 maternal phenotypes assessed during and outside of pregnancy and 71 offspring phenotypes assessed in childhood (<10 years) and adolescence (11–18 years).FindingsThe maternal smoking and caffeine GRS were associated with maternal smoking and caffeine consumption during pregnancy (2nd trimester: Psmoking = 3.0 × 10−7, Pcaffeine = 3.28 × 10−5). Both the maternal and offspring smoking GRS showed evidence of association with reduced childhood anxiety symptoms (βmaternal = −0.033; βoffspring = −0.031) and increased conduct disorder symptoms (βmaternal = 0.024; βoffspring = 0.030), after correcting for multiple testing. Finally, the maternal and offspring smoking GRS were associated with phenotypes related to sensation seeking behaviours in mothers and adolescence (e.g. increased symptoms of externalising disorders, extraversion and monotony avoidance). The caffeine GRS showed weaker evidence for associations with mental health outcomes.ConclusionsWe did not find strong evidence that maternal smoking and caffeine genetic risk scores have a causal effect on offspring mental health outcomes. Our results confirm that the smoking genetic risk scores also captures liability for sensation seeking personality traits.

Association Between Maternal Caffeine Consumption and Metabolism and Neonatal Anthropometry

Higher caffeine consumption during pregnancy has been associated with lower birth weight. However, associations of caffeine consumption, based on both plasma concentrations of caffeine and its metabolites, and self-reported caffeinated beverage intake, with multiple measures of neonatal anthropometry, have yet to be examined. To evaluate the association between maternal caffeine intake and neonatal anthropometry, testing effect modification by fast or slow caffeine metabolism genotype. A longitudinal cohort study, the National Institute of Child Health and Human Development Fetal Growth Studies-Singletons, enrolled 2055 nonsmoking women at low risk for fetal growth abnormalities with complete information on caffeine consumption from 12 US clinical sites between 2009 and 2013. Secondary analysis was completed in 2020. Caffeine was evaluated by both plasma concentrations of caffeine and paraxanthine and self-reported caffeinated beverage consumption measured/reported at 10-13 weeks gestation. Caffeine metabolism defined as fast or slow using genotype information from the single nucleotide variant rs762551 (CYP1A2*1F). Neonatal anthropometric measures, including birth weight, length, and head, abdominal, arm, and thigh circumferences, skin fold and fat mass measures. The β coefficients represent the change in neonatal anthropometric measure per SD change in exposure. A total of 2055 participants had a mean (SD) age of 28.3 (5.5) years, mean (SD) body mass index of 23.6 (3.0), and 580 (28.2%) were Hispanic, 562 (27.4%) were White, 518 (25.2%) were Black, and 395 (19.2%) were Asian/Pacific Islander. Delivery occurred at a mean (SD) of 39.2 (1.7) gestational weeks. Compared with the first quartile of plasma caffeine level (≤28 ng/mL), neonates of women in the fourth quartile (>659 ng/mL) had lower birth weight (β = -84.3 g; 95% CI, -145.9 to -22.6 g; P = .04 for trend), length (β = -0.44 cm; 95% CI, -0.78 to -0.12 cm; P = .04 for trend), and head (β = -0.28 cm; 95% CI, -0.47 to -0.09 cm; P < .001 for trend), arm (β = -0.25 cm; 95% CI, -0.41 to -0.09 cm: P = .02 for trend), and thigh (β = -0.29 cm; 95% CI, -0.58 to -0.04 cm; P = .07 for trend) circumference. Similar reductions were observed for paraxanthine quartiles, and for continuous measures of caffeine and paraxanthine concentrations. Compared with women who reported drinking no caffeinated beverages, women who consumed approximately 50 mg per day (~ 1/2 cup of coffee) had neonates with lower birth weight (β = -66 g; 95% CI, -121 to -10 g), smaller arm (β = -0.17 cm; 95% CI, -0.31 to -0.02 cm) and thigh (β = -0.32 cm; 95% CI, -0.55 to -0.09 cm) circumference, and smaller anterior flank skin fold (β = -0.24 mm; 95% CI, -0.47 to -0.01 mm). Results did not differ by fast or slow caffeine metabolism genotype. In this cohort study, small reductions in neonatal anthropometric measurements with increasing caffeine consumption were observed. Findings suggest that caffeine consumption during pregnancy, even at levels much lower than the recommended 200 mg per day of caffeine, are associated with decreased fetal growth.

The data we have: Pregnancy and birth related data collection in Australia, Canada, Europe and the USA - A web-based survey of practice.

ObjectivesTo determine the feasibility of combining routinely recorded perinatal data from several databases in high-income countries to assess the risk of recurrent stillbirth.MethodsWeb-based questionnaire survey with reminder emails and searching of relevant country websites.Results120 countries/regions in Canada, Europe and the USA were invited to participate and 83 (69%) responded. Of those one had no data, and two did not wish to take part. The remaining 80 were sent the questionnaire and 63 (53%) were completed. Twenty-seven countries/regions reported that they collect information on all perinatal events (including early pregnancy loss), 34 on live births and stillbirths and two only live births (stillbirths recorded in a separate database). Most countries (53/63) can link two or more pregnancies occurring in the same woman. Data and information extracted from the Australian and New Zealand Government websites showed that information on all perinatal events is collected nationally in New Zealand and in 5/8 regions in Australia. Both Australia and New Zealand can link two or more pregnancies occurring in the same woman. Maternal age and caffeine consumption were the most and least consistently collected demographic indicators respectively. Diabetes mellitus and mental health problems, birthweight and obstetric cholestasis the most and least consistently collected for medical conditions and pregnancy condition/complications. Procedures for gaining access to data vary between countries.ConclusionThis study demonstrates that it is possible to link pregnancies in the same woman to assess the risk of recurrent stillbirth using routinely collected perinatal data in all states/territories in Australia, 7/8 responding provinces/territories in Canada, 21/27 responding countries/regions in Europe, New Zealand and 26/28 responding states in the USA. The scope of the databases and quality and extent of data collected (thus their potential use) varied, as did procedures for accessing their data.

Caffeine exposure during pregnancy: Is it safe?

Numerous studies have examined the association between maternal caffeine consumption and infant and childhood health outcomes and the results have been inconsistent. The study of maternal caffeine intake and infant and childhood health outcomes is prone to methodologic challenges. In this review, we examine the existing evidence juxtaposed with the epidemiologic design challenges that color the interpretation of the study results presented. In light of methodologic/interpretation challenges, it seems reasonable to infer that exposure to low levels of caffeine is probably not associated with substantial infant and childhood adversities. However, more research is needed using well designed studies that address methodologic challenges.

Impact of Maternal Sleep Deprivation and Caffeine Consumption on Neurodevelopmental and Behavioural Outcomes in Young Rats

Caffeine is a neurostimulant, which has been shown to be both cognitive‐enhancing and sleep‐disrupting. Several reports agree that caffeine and sleep deprivation have opposing effects on behaviours, including cogntive and depressive behaviours. Therefore, this study was designed to evaluate the neurodevelopmental and behavioural outcomes following prenatal and postnatal caffeine treatment and chronic sleep deprivation in rats. Pregnant Long‐Evans rats were sleep‐deprived 8 h/day in the last trimester of gestation using the platform‐over‐water sleep deprivation model; and treated orally with 120 mg/kg of caffeine from gestation day 8 and throughout lactation. Learning and memory, social, anxiety‐like and depressive‐like behaviours were assessed in the prepubescent rats (Postnatal Date 35). The young rats exhibited a higher anxiety level, as revealed by higher open field entry frequencies. They performed poorly in the novel object recognition test, and displayed abnormal sociability and social novelty in the social tests. Additionally, there was decreased hippocampal serotonergic activity and a marked reduction in synaptic protein expression in the CA1 hippocampal region, the prefrontal cortex and amygdala. Taken together, this study suggests that prenatal and postnatal sleep deprivation and caffeine consumption can interfere with brain development and thus impact behavioural outcomes, which could increase susceptibility to neurological disorders in adulthood.

Caffeine use during pregnancy: prevalence of use and newborn consequences in a cohort of French pregnant women.

Many pregnant women, in the world, drink caffeine-containing beverages. Maternal caffeine consumption during pregnancy may have adverse effects on foetus but results are conflicting. Our goals were to estimate the prevalence of caffeine use in a cohort of French pregnant women using maternal self-reports and to evaluate the association between caffeine consumption during pregnancy and delivery and newborn characteristics. All pregnant women who gave birth in a large French urban area during a limited period of time were included (in total 724 mothers were included). Coffee, tea or cola consumption as well as pregnancy and neonate characteristics were analysed. The mean consumption of caffeine per day slightly decreased from the first to the third trimester of pregnancy: 587 caffeine users, with a consumption of caffeine of 59.2 ± 61.5mg/day during the first trimester as compared to 577 consumers (54.3 ± 55.4mg/day) during the third trimester, respectively. A significant decrease of neonates' birth length was observed when mothers were using at least 100mg/day (or two cups) of caffeine during the second and third trimesters but this difference was no longer significant after adjustment on potential confounding factors such as tobacco use. The potential existence of other confounders (e.g. poorer dietary habits or other lifestyle variables) that might also be associated with reduced birth length, may not be excluded. Caffeine use during pregnancy was associated with reduced birth length but this effect was no longer significant after adjustment on potential confounding variables.