Greenwood, DC, Thatcher, NJ, Ye, J et al. (4 more authors) (2014) Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose–response meta-analysis. European Journal of Epidemiology, 29 (10). 725 - 734. ISSN 0393-2990
Abstract
Caffeine is commonly consumed during pregnancy, crosses the placenta, with fetal serum concentrations similar to the mother’s, but studies of birth outcome show conflicting findings. We systematically searched Medline and Embase for relevant publications. We conducted meta-analysis of dose–response curves for associations between caffeine intake and spontaneous abortion, stillbirth, preterm delivery, low birth weight and small for gestational age (SGA) infants. Meta-analyses included 60 unique publications from 53 cohort and case–control studies. An increment of 100 g caffeine was associated with a 14 % (95 % CI 10–19 %) increase in risk of spontaneous abortion, 19 % (5–35 %) stillbirth, 2 % (-2 to 6 %) preterm delivery, 7 % (1–12 %) low birth weight, and 10 % (95 % CI 6–14 %) SGA. There was substantial heterogeneity in all models, partly explained by adjustment for smoking and previous obstetric history, but not by prospective assessment of caffeine intake. There was evidence of small-study effects such as publication bias. Greater caffeine intake is associated with an increase in spontaneous abortion, stillbirth, low birth weight, and SGA, but not preterm delivery. There is no identifiable threshold below which the associations are not apparent, but the size of the associations are generally modest within the range of usual intake and are potentially explained by bias in study design or publication. There is therefore insufficient evidence to support further reductions in the maximum recommended intake of caffeine, but maintenance of current recommendations is a wise precaution.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2014, Springer Science+Business Media Dordrecht. This is an author produced version of a paper published in European Journal of Epidemiology. Uploaded in accordance with the publisher's self-archiving policy. The final publication is available at Springer via http://dx.doi.org/10.1007/s10654-014-9944-x |
Keywords: | Caffeine; Pregnancy; Miscarriage; Stillbirth; Preterm birth; Birth weight; Small for gestational age infant; Meta-analysis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Genetics, Health and Therapeutics (LIGHT) > Division of Epidemiology & Biostatistics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 Oct 2014 11:25 |
Last Modified: | 04 Nov 2017 02:45 |
Published Version: | http://dx.doi.org/10.1007/s10654-014-9944-x |
Status: | Published |
Publisher: | Springer Verlag |
Identification Number: | 10.1007/s10654-014-9944-x |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:80423 |