American Journal of Epidemiology Vol. 147, No. 5: 503-510
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Rate of Caffeine Metabolism and Risk of Spontaneous Abortion
1Reproductive Epidemiology Section, Department of Health Services Emeryville, CA
2Kaiser Permanente Division of Research Oakland, CA
3Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California San Francisco, CA
In a case-control study of 73 women with and 141 women without spontaneous abortion, the authors determined the activity of the three principal caffeine-metabolizing enzymescytochrome P-4501A2 (CYP1A2), xanthine oxidase, and N-acetyltransferase 2by measuring levels of caffeine metabolites in urine. After examining the effect of enzyme activity and different levels of caffeine intake, they concluded that there was no evidence that an interaction between enzyme activity and caffeine intake during pregnancy resulted in risk of spontaneous abortion. In a subsample comparing 24 cases with recurrent (two or more) spontaneous abortions and 21 controls with two or more livebirths and no previous spontaneous abortions, the unadjusted odds ratio for low CYP1A2 enzyme activity (below the median) was 0.92 (95% confidence interval (CI) 0.28-3.04) compared with higher CYP1A2 activity. The odds ratio for risk of recurent spontaneous abortion and low xanthine oxidase activity (below the median) versus higher activity was 0.37 (95% CI 0.101.29). Phenotypically slow acetyiators (N-acetyltransferase 2 index <0.37) had an odds ratio of 1.58 (95% CI 0.48-5.13) for recurrent loss compared with rapid acetylators. Thus, some association of the latter two caffeine-metabolizing enzymes with recurrent spontaneous abortion is suggested but may also be due to chance. Am J Epidemiol 1998; 147:50310.
abortion; acetyltransferases; caffeine; cytochrome P-450; metabolism; xanthine oxidase
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