CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(12): 749-756
DOI: 10.1055/s-0038-1675806
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Association between Caffeine Consumption in Pregnancy and Low Birth Weight and Preterm Birth in the birth Cohort of Ribeirão Preto

Associação entre consumo de cafeína durante a gestação com baixo peso ao nascer e nascimento pré-termo na coorte de Ribeirão Preto
Fernanda Pino Vitti
1   Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Carlos Grandi
2   Department of Pediatrics, Facultad de Medicina de la Universidad de Buenos Aires, Argentina
,
Ricardo de Carvalho Cavalli
3   Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Vanda Maria Ferreira Simões
4   Department of Public Health, Universidade Federal do Maranhão, São Luiz, MA, Brazil
,
Rosângela Fernandes Lucena Batista
4   Department of Public Health, Universidade Federal do Maranhão, São Luiz, MA, Brazil
,
Viviane Cunha Cardoso
1   Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brazil
› Author Affiliations
Further Information

Publication History

28 May 2018

20 September 2018

Publication Date:
07 December 2018 (online)

Abstract

Objective To describe caffeine consumption during pregnancy and its association with low birth weight (LBW) and preterm birth in the birth cohort of Ribeirão Preto, state of São Paulo, Brazil, in 2010.

Methods Cohort study, with descriptive and analytical approach. Data included 7,607 women and their newborns in Ribeirão Preto, state of São Paulo, Brazil. The women answered standardized questionnaires about reproductive health, prenatal care, life habits, sociodemographic conditions, and information about coffee intake. The independent variable was high caffeine consumption (≥300 mg/day) from coffee during pregnancy, and the dependent variables were LBW (birth weight < 2,500 g) and preterm birth (< 37 weeks of gestational age). Four adjusted polytomous logistic regression models, relative risk (RR) and 95% confidence interval (CI) were fitted: biological and sociodemographic conditions; obstetric history; current gestational conditions; and all variables included in the previous models.

Results A total of 4,908 (64.5%) mothers consumed caffeine, 143 (2.9%) of whom reported high consumption. High caffeine intake was significantly associated with reduced education and with the occupation of the head of the family, nonwhite skin color, not having a partner, higher parity, previous abortion and preterm birth, urinary tract infection, threatened abortion, alcohol consumption and smoking. No association was found between high caffeine consumption and LBW or preterm birth in both unadjusted (RR = 1.45; 95% CI: 0.91–2.32; and RR = 1.16; 95% CI: 0.77–1.75, respectively) and adjusted analyses (RR = 1.42; 95% CI: 0.85–2.38; and RR = 1.03; 95% CI: 0.65–1.63, respectively).

Conclusion In this cohort, high caffeine intake was lower than in other studies and no association with LBW or preterm birth was found.

Resumo

Objetivo Descrever a associação entre consumo de cafeína durante a gestação com baixo peso ao nascer (BPN) e nascimento pré-termo (PT) na coorte de Ribeirão Preto, estado de São Paulo, Brasil, em 2010.

Métodos Estudo de coorte, com abordagem descritiva e analítica. Foram incluídas 7.607 mulheres e seus recém-nascidos em Ribeirão Preto, São Paulo, Brasil. As mulheres responderam a questionários padronizados sobre saúde reprodutiva, cuidados pré-natais, hábitos de vida, condições sociodemográficas e consumo de cafeína. A variável independente foi alto consumo de cafeína (≥300 mg/dia) durante a gestação e as dependentes foram BPN (peso < 2.500 g) e nascimento PT (< 37 semanas de gestação). Foram calculados riscos relativos (RRs) e intervalos de confiança (ICs) de 95% em quatro modelos de regressão logística: condições biológicas e sociodemográficas; história obstétrica; condições da gestação atual; e todas as variáveis incluídas nos modelos anteriores.

Resultados Um total de 4.908 (64,5%) mães consumiram cafeína, e destas, 143 (2,9%) relataram alto consumo. Alto consumo de cafeína esteve associado com menor escolaridade materna, ocupação do chefe da família, cor de pele não branca, mulheres sem companheiro, maior paridade, aborto e nascimento PT anterior, infecção do trato urinário, ameaça de aborto, consumo de álcool e tabagismo. Não foi encontrada associação entre alto consumo de cafeína e BPN ou nascimento PT nas análises não ajustada (RR = 1,45; IC 95%: 0,91–2,32; e RR = 1,16; IC 95%: 0,77–1,75, respectivamente) e ajustada (RR = 1,42; IC 95%: 0,85–2,38; e RR = 1,03; IC 95%: 0,65–1,63, respectivamente).

Conclusão Nessa coorte, o alto consumo de cafeína foi menor que em outros estudos e não foi encontrada associação com BPN ou nascimento PT.

Contributions

All the authors participated in the selection of the theme, in the gathering of references and in the study design. Fernanda Vitti performed the data collection and wrote the article. Carlos Grandi performed the data analysis and the interpretation of the results. Ricardo de Carvalho Cavalli, Vanda Maria Ferreira Simões and Rosângela Fernandes Lucena Batista reviewed the article, and all the authors gave their approval of the final version. Viviane Cunha Cardoso guided the other authors through the interpretation of the data and performed a critical review.


 
  • References

  • 1 Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam 2003; 20 (01) 1-30 Doi: 10.1080/0265203021000007840
  • 2 Clausson B, Granath F, Ekbom A. , et al. Effect of caffeine exposure during pregnancy on birth weight and gestational age. Am J Epidemiol 2002; 155 (05) 429-436 Doi: 10.1093/aje/155.5.429
  • 3 Chiaffarino F, Parazzini F, Chatenoud L. , et al. Coffee drinking and risk of preterm birth. Eur J Clin Nutr 2006; 60 (05) 610-613 Doi: 10.1038/sj.ejcn.1602358
  • 4 Maslova E, Bhattacharya S, Lin SW, Michels KB. Caffeine consumption during pregnancy and risk of preterm birth: a meta-analysis. Am J Clin Nutr 2010; 92 (05) 1120-1132 Doi: 10.3945/ajcn.2010.29789
  • 5 Pastore LM, Savitz DA. Case-control study of caffeinated beverages and preterm delivery. Am J Epidemiol 1995; 141 (01) 61-69 Doi: 10.1093/oxfordjournals.aje.a117346
  • 6 Berkowitz GS, Holford TR, Berkowitz RL. Effects of cigarette smoking, alcohol, coffee and tea consumption on preterm delivery. Early Hum Dev 1982; 7 (03) 239-250 Doi: 10.1016/0378-3782(82)90086-X
  • 7 Bakker R, Steegers EA, Obradov A, Raat H, Hofman A, Jaddoe VW. Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: the Generation R Study. Am J Clin Nutr 2010; 91 (06) 1691-1698 Doi: 10.3945/ajcn.2009.28792
  • 8 van der Hoeven T, Browne JL, Uiterwaal CSPM, van der Ent CK, Grobbee DE, Dalmeijer GW. Antenatal coffee and tea consumption and the effect on birth outcome and hypertensive pregnancy disorders. PLoS One 2017; 12 (05) e0177619 Doi: 10.1371/journal.pone.0177619
  • 9 Vlajinac HD, Petrović RR, Marinković JM, Sipetić SB, Adanja BJ. Effect of caffeine intake during pregnancy on birth weight. Am J Epidemiol 1997; 145 (04) 335-338 Doi: 10.1093/oxfordjournals.aje.a009110
  • 10 Godel JC, Pabst HF, Hodges PE, Johnson KE, Froese GJ, Joffres MR. Smoking and caffeine and alcohol intake during pregnancy in a northern population: effect on fetal growth. CMAJ 1992; 147 (02) 181-188
  • 11 Bicalho GG, Barros Filho AdeA. Peso ao nascer e influência do consumo de cafeína. Rev Saude Publica 2002; 36 (02) 180-187 Doi: 10.1590/S0034-89102002000200010
  • 12 Koren G. Caffeine during pregnancy? In moderation. Can Fam Physician 2000; 46: 801-803
  • 13 Kirkinen P, Jouppila P, Koivula A, Vuori J, Puukka M. The effect of caffeine on placental and fetal blood flow in human pregnancy. Am J Obstet Gynecol 1983; 147 (08) 939-942 Doi: 10.1016/0002-9378(83)90250-8
  • 14 Camargo MC, Toledo MC, Farah HG. Caffeine daily intake from dietary sources in Brazil. Food Addit Contam 1999; 16 (02) 79-87 Doi: 10.1080/026520399284244
  • 15 Caan BJ, Goldhaber MK. Caffeinated beverages and low birthweight: a case-control study. Am J Public Health 1989; 79 (09) 1299-1300
  • 16 Srisuphan W, Bracken MB. Caffeine consumption during pregnancy and association with late spontaneous abortion. Am J Obstet Gynecol 1986; 154 (01) 14-20 Doi: 10.1016/0002-9378(86)90385-6
  • 17 Olsen J, Overvad K, Frische G. Coffee consumption, birthweight, and reproductive failures. Epidemiology 1991; 2 (05) 370-374 Doi: 10.1097/00001648-199109000-00011
  • 18 Mills JL, Holmes LB, Aarons JH. , et al. Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation. JAMA 1993; 269 (05) 593-597
  • 19 Higdon JV, Frei B. Coffee and health: a review of recent human research. Crit Rev Food Sci Nutr 2006; 46 (02) 101-123 Doi: 10.1080/10408390500400009
  • 20 Fenster L, Eskenazi B, Windham GC, Swan SH. Caffeine consumption during pregnancy and fetal growth. Am J Public Health 1991; 81 (04) 458-461 Doi: 10.2105/AJPH.81.4.458
  • 21 Martin TR, Bracken MB. The association between low birth weight and caffeine consumption during pregnancy. Am J Epidemiol 1987; 126 (05) 813-821 Doi: 10.1093/oxfordjournals.aje.a114718
  • 22 Kaiser L, Allen LH. ; American Dietetic Association. Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc 2008; 108 (03) 553-561 Doi: 10.1016/j.jada.2008.01.030
  • 23 Cardoso VC, Simões VMF, Barbieri MA. , et al. Profile of three Brazilian birth cohort studies in Ribeirão Preto, SP and São Luís, MA. Braz J Med Biol Res 2007; 40 (09) 1165-1176 Doi: 10.1590/S0100-879 × 2006005000148
  • 24 CARE Study Group. Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. BMJ 2008; 337: a2332 Doi: 10.1136/bmj.a2332
  • 25 Olsen J, Frische G. Social differences in reproductive health. A study on birth weight, stillbirths and congenital malformations in Denmark. Scand J Soc Med 1993; 21 (02) 90-97 Doi: 10.1177/140349489302100206
  • 26 von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. ; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007; 335 (7624): 806-808 Doi: 10.1136/bmj.39335.541782.AD
  • 27 Pacheco AHRN, Araujo DMR, Lacerda EMA, Kac G. [Caffeine consumption by pregnant women selected from a Health Care Center in the municipality of Rio de Janeiro, Brazil]. Rev Bras Ginecol Obstet 2008; 30 (05) 232-240 Doi: 10.1590/S0100-72032008000500005
  • 28 Santos IS, Victora CG, Huttly S, Carvalhal JB. Caffeine intake and low birth weight: a population-based case-control study. Am J Epidemiol 1998; 147 (07) 620-627 Doi: 10.1093/oxfordjournals.aje.a009502
  • 29 Pacheco AHRN, Barreiros NSR, Santos IS, Kac G. Consumo de cafeína entre gestantes e a prevalência do baixo peso ao nascer e da prematuridade: uma revisão sistemática. Cad Saude Publica 2007; 23 (12) 2807-2819 Doi: 10.1590/S0102-311 × 2007001200002
  • 30 Fortier I, Marcoux S, Beaulac-Baillargeon L. Relation of caffeine intake during pregnancy to intrauterine growth retardation and preterm birth. Am J Epidemiol 1993; 137 (09) 931-940 Doi: 10.1093/oxfordjournals.aje.a116763
  • 31 Chen LW, Wu Y, Neelakantan N, Chong MFF, Pan A, van Dam RM. Maternal caffeine intake during pregnancy is associated with risk of low birth weight: a systematic review and dose-response meta-analysis. BMC Med 2014; 12: 174-185 Doi: 10.1186/s12916-014-0174-6
  • 32 Greenwood DC, Thatcher NJ, Ye J. , et al. Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 2014; 29 (10) 725-734 Doi: 10.1007/s10654-014-9944-x
  • 33 Peacock JL, Bland JM, Anderson HR. Effects on birthweight of alcohol and caffeine consumption in smoking women. J Epidemiol Community Health 1991; 45 (02) 159-163
  • 34 Bech BH, Obel C, Henriksen TB, Olsen J. Effect of reducing caffeine intake on birth weight and length of gestation: randomised controlled trial. BMJ 2007; 334 (7590): 409 Doi: 10.1136/bmj.39062.520648.BE
  • 35 Sengpiel V, Elind E, Bacelis J. , et al. Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study. BMC Med 2013; 11: 42-59 Doi: 10.1186/1741-7015-11-42