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Review
. 2015 Jun 9;2015(6):CD006965.
doi: 10.1002/14651858.CD006965.pub4.

Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcomes

Shayesteh Jahanfar  1 , Sharifah Halimah Jaafar
Affiliations
Review

Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcomes

Shayesteh Jahanfar et al. Cochrane Database Syst Rev. .

Abstract

Background: Maternal caffeine consumption during pregnancy may have adverse effects on fetal, neonatal and maternal outcomes.

Objectives: This review investigates the effects of restricting caffeine intake by mothers on fetal, neonatal and pregnancy outcomes.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (16 January 2015), scanned bibliographies of published studies and corresponded with investigators.

Selection criteria: Randomised controlled trials (RCTs) including quasi-RCTs investigating the effect of caffeine and/or supplementary caffeine versus restricted caffeine intake or placebo on pregnancy outcomes.

Data collection and analysis: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy.

Main results: Two studies met the inclusion criteria but only one contributed data for the prespecified outcomes. Caffeinated instant coffee (568 women) was compared with decaffeinated instant coffee (629 women) and it was found that reducing the caffeine intake of regular coffee drinkers (3+ cups/day) during the second and third trimester by an average of 182 mg/day did not affect birthweight (g) (mean difference (MD) 20.00, 95% confidence interval (CI) -48.68 to 88.68; one study, 1197 participants; low quality evidence), preterm birth (risk ratio (RR) 0.81, 95% CI 0.48 to 1.37; one study, 1153 participants; low quality evidence) or small-for-gestational age (RR 0.97, 95% 0.57 to 1.64; one study, 1150 participants). Risk of bias was moderate in both studies.Two outcomes were assessed and assigned a quality rating using the GRADE methods. Evidence for these two outcomes (birthweight and preterm birth) was assessed as of low quality, with downgrading decisions due to the relatively small sample sizes and the wide confidence interval of the one included trial that contributed data. Neither of the studies reported on any of the other primary outcomes (low birthweight; first trimester fetal loss; perinatal mortality; fetal hypoxia; fetal tachycardia) or on any of the reviews neonatal or maternal outcomes.

Authors' conclusions: There is insufficient evidence to confirm or refute the effectiveness of caffeine avoidance on birthweight or other pregnancy outcomes. There is a need to conduct high-quality, double-blinded RCTs to determine whether caffeine has any effect on pregnancy outcome.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Caffeinated (experimental group) versus decaffeinated group (control group), Outcome 1 Birthweight (grams).
1.2
1.2. Analysis
Comparison 1 Caffeinated (experimental group) versus decaffeinated group (control group), Outcome 2 Preterm birth.
1.3
1.3. Analysis
Comparison 1 Caffeinated (experimental group) versus decaffeinated group (control group), Outcome 3 Small‐for‐gestational age.
1.4
1.4. Analysis
Comparison 1 Caffeinated (experimental group) versus decaffeinated group (control group), Outcome 4 Glucose tolerance ‐ serum Insulin (pmol/L) (not prespecified).
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References

References to studies included in this review

Bech 2007 {published data only}
    1. 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;334:409. - PMC - PubMed
Robinson 2009 {published data only}
    1. Robinson LE, Spafford C, Grahan TE, Smith GN. Acute caffeine ingestion and glucose tolerance in women with or without gestational diabetes mellitus. Journal of Obstetrics and Gynecology Canada 2009;31(4):304‐12. - PubMed

Additional references

Adeney 2007
    1. Adeney KL, Williams MA, Schiff MA, Qiu C, Sorensen TK. Coffee consumption and the risk of gestational diabetes mellitus. Acta Obstetricia et Gynecologica Scandinavica 2007;86(2):161‐6. - PubMed
Aldridge 1979
    1. Aldridge A, Aranda JV, Neims AH. Caffeine metabolism in the newborn. Clinical Pharmacology and Therapeutics 1979;25:447‐53. - PubMed
Back 2006
    1. Back SA, Craig A, Luo NL, Ren J, Akundi RS, Ribeiro I, et al. Protective effects of caffeine on chronic hypoxia‐induced perinatal white matter injury. Annals of Neurology 2006;60(6):696‐705. - PubMed
Bech 2005
    1. Bech BH, Nohr EA, Vaeth M, Henriksen TB, Olsen J. Coffee and fetal death: a cohort study with prospective data. American Journal of Epidemiology 2005;162(10):983‐90. - PubMed
Berger 1988
    1. Berger A. Effects of caffeine consumption on pregnancy outcomes. Journal of Reproductive Medicine 1988;33:945‐56. - PubMed
Bodineau 2006
    1. Bodineau L, Saadani‐Makki F, Jullien H, Frugiere A. Caffeine in the milk prevents respiratory disorders caused by in utero caffeine exposure in rats. Respiratory Physiology and Neurobiology 2006;150(1):94‐8. - PubMed
Bracken 2003
    1. Bracken MB, Triche EW, Belanger K, Hellenbrand K, Leaderer BP. Association of maternal caffeine consumption with decrements in fetal growth. American Journal of Epidemiology 2003;157(5):456‐66. - PubMed
Browne 2006
    1. Browne ML. Maternal exposure to caffeine and risk of congenital anomalies: a systematic review. Epidemiology 2006;17(3):324‐31. - PubMed
Browne 2007
    1. Browne ML, Bell EM, Druschel CM, Gensburg LJ, Mitchell AA, Lin AE, et al. Maternal caffeine consumption and risk of cardiovascular malformations. Birth Defects Research. Part A, Clinical and Molecular Teratology 2007; Vol. 79, issue 7:533‐43. - PubMed
Bruyere 1987
    1. Bruyere HJ, Michaud BJ, Gilbert EF, Folts JD. The effects of cardioteratogenic doses of caffeine on cardiac function in the 3‐day chick embryo. Journal of Applied Toxicology 1987;7(3):197‐203. - PubMed
Clausson 2002
    1. Clausson B, Granath F, Ekbom A, Lundgren S, Nordmark A, Signorello LB, et al. Effect of caffeine exposure during pregnancy on birth weight and gestational age. American Journal of Epidemiology 2002;155:429‐36. - PubMed
Elmazar 1982
    1. Elmazar MM, McElhatton PR, Sullivan FM. Studies on the teratogenic effects of different oral preparations of caffeine in mice. Toxicology 1982;23(1):57‐71. - PubMed
Ford 1988
    1. Ford RPK, Schluter PJ, Mitchell EA, Sragg R, Stewart AW, New Zealand Cot Death Study Group. Heavy caffeine intake in pregnancy and sudden infant death syndrome. Archives of Disease in Childhood 1988;78:9‐13. - PMC - PubMed
Gaytan 2006
    1. Gaytan SP, Saadani‐Makki F, Bodineau L, Frugiere A, Larnicol N, Pasaro R. Effect of postnatal exposure to caffeine on the pattern of adenosine A1 receptor distribution in respiration‐related nuclei of the rat brainstem. Autonomic Neuroscience 2006;126:339‐46. - PubMed
GRADEpro 2014 [Computer program]
    1. McMaster University. GRADEpro. [Computer program on www.gradepro.org]. Version [2014]. McMaster University, 2014.
Grosso 2006
    1. Grosso LM, Triche EW, Belanger K, Benowitz NL, Holford TR, Bracken MB. Caffeine metabolites in umbilical cord blood, cytochrome P‐450 1A2 activity, and intrauterine growth restriction. American Journal of Epidemiology 2006;163(11):1035‐41. - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Iglesias 2006
    1. Iglesias I, Leon D, Ruiz MA, Albasanz JL, Martin M. Chronic intake of caffeine during gestation down regulates metabotropic glutamate receptors in maternal and fetal rat heart. Amino Acids 2006;30(3):257‐66. - PubMed
Kirkinen 1983
    1. Kirkinen P, Jouppila P, Koivula A. The effect of caffeine on placental and fetal blood flow in human pregnancy. American Journal of Obstetrics and Gynecology 1983;147:939‐42. - PubMed
Klebanoff 2002
    1. Klebanoff MA, Levine RJ, Clemens JD, Wilkins DG. Maternal serum caffeine metabolites and small for gestational age birth. American Journal of Epidemiology 2002;155(1):32‐7. - PubMed
Knutti 1981
    1. Knutti R, Rothweiler H, Schlatter C. Effect of pregnancy on the pharmacokinetics of caffeine. European Journal of Clinical Pharmacology 1981;21(2):121‐6. - PubMed
Knutti 1982
    1. Knutti R, Rothweiler H, Schlatter C. The effect of pregnancy on the pharmacokinetics of caffeine. Archives of Toxicology. Supplement 1982;5:187‐92. - PubMed
Leon 2002
    1. Leon D, Albasanz JL, Ruiz MA, Fernandez M, Martin M. Adenosine A1 receptor down‐regulation in mothers and fetal brain after caffeine and theophylline treatments to pregnant rats. Journal of Neurochemistry 2002;82:625‐34. - PubMed
Martinet 2002
    1. Martinet Y, Debry G. Effects of coffee on the respiratory system. Revue des Maladies Respiratoires 1992;9(6):587‐92. - PubMed
McGowan 1988
    1. McGowan JD, Altman RE, Roy E, Kanto WP Jr. Neonatal withdrawal symptoms after chronic maternal ingestion of caffeine. Southern Medical Journal 1988;81(9):1092‐4. - PubMed
Resch 1983
    1. Resch BA, Papp JG. Effects of caffeine on the fetal heart. American Journal of Obstetrics and Gynecology 1983;146:231‐2. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rondo 1996
    1. Rondo PH, Rodrigues LC, Tomkins AM. Coffee consumption and intrauterine growth retardation in Brazil. European Journal of Clinical Nutrition 1996;50(11):705‐9. - PubMed
Schunemann 2009
    1. Schunemann HJ. GRADE: from grading the evidence to developing recommendations. A description of the system and a proposal regarding the transferability of the results of clinical research to clinical practice [GRADE: Von der Evidenz zur Empfehlung. Beschreibung des Systems und Losungsbeitrag zur Ubertragbarkeit von Studienergebnissen]. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen 2009;103(6):391‐400. [PUBMED: 19839216] - PubMed
Tolstrup 1983
    1. Tolstrup JS, Kjaer SK, Munk C, Madsen LB, Ottesen B, Bergholt T, et al. Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?. Human Reproduction 2003;18(12):2704‐10. - PubMed
Wen 2001
    1. Wen W, Shu XO, Jacobs DR Jr, Brown JE. The associations of maternal caffeine consumption and nausea with spontaneous abortion. Epidemiology 2001;12(1):38‐42. - PubMed
Wisborg 2002
    1. Wisborg K, Kesmodel U, Bech BH, Hedegaard M, Henriksen TB. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study. BMJ 2002;326:420‐5. - PMC - PubMed

References to other published versions of this review

Jahanfar 2008
    1. Jahanfar S, Sharifah H. Modifications of maternal caffeine intake for improving pregnancy outcome. Cochrane Database of Systematic Reviews 2008, Issue 1. [DOI: 10.1002/14651858.CD006965] - DOI - PubMed
Jahanfar 2009
    1. Jahanfar S, Jaafar SH. Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD006965.pub2] - DOI - PubMed
Jahanfar 2013
    1. Jahanfar S, Jaafar SH. Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome. Cochrane Database of Systematic Reviews 2013, Issue 2. [DOI: 10.1002/14651858.CD006965.pub3] - DOI - PubMed

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