Am J Epidemiol 2003; 157:456-466.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Association of Maternal Caffeine Consumption with Decrements in Fetal Growth
1 Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
2 Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT.
3 Department of Neurology, Yale University School of Medicine, New Haven, CT.
Whether caffeine consumption during pregnancy represents a fetal hazard remains uncertain. The authors report on a large prospective study designed to examine this question. In 1996–2000, 2,291 mothers with singleton livebirths in Connecticut and Massachusetts were evaluated after their first prenatal visit and were questioned about caffeine consumption and important confounding factors. Urine samples were provided to analyze urinary caffeine, cotinine, and creatinine levels. Mothers were followed throughout pregnancy to monitor changes in consumption. Pregnancy outcomes were obtained from medical records. Self-reports of caffeine consumption in the first and third trimesters were not associated with intrauterine growth retardation, low birth weight, or preterm delivery. For every 1 mg/g creatinine increase in urinary caffeine, risk of intrauterine growth retardation was essentially unchanged (odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.85, 1.08). In contrast, a 0.005 mg/g creatinine increase in urinary cotinine significantly increased risk (OR = 1.003, 95% CI: 1.001, 1.005). Mean birth weight was reduced by reported caffeine consumption (–28 g per 100 mg of caffeine consumed daily, 95% CI: –0.10, –0.46, p = 0.001) but not mean gestational age. Decaffeinated coffee did not increase risk for any perinatal outcome. This small decrease in birth weight, observed for maternal caffeine consumption, is unlikely to be clinically important except for women consuming 
600 mg of caffeine daily (approximately six 10-ounce (1 ounce = 28.3 g) cups of coffee).
birth weight; caffeine; coffee; fetal growth retardation; gestational age; pregnancy; reproduction
Abbreviations: Abbreviations: CI, confidence interval; IUGR, intrauterine growth retardation; OR, odds ratio.
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