The Arizona Republic

Study: Avoid caffeine if pregnant

- E.J. Mundell

Women who are pregnant or trying to get pregnant may need to forgo coffee, tea, sodas and other sources of caffeine. A new data analysis finds no safe level of the drug during this time.

“The cumulative scientific evidence supports pregnant women and women contemplat­ing pregnancy being advised to avoid caffeine,” concluded study author Jack James, a professor at Reykjavik University in Iceland.

The findings challenge current U.S. expert recommenda­tions from organizati­ons such as the March of Dimes and the American College of Obstetrici­ans and Gynecologi­sts. Those guidelines say that consuming a small amount of caffeine each day — 200 milligrams, equal to about a cup or two of coffee — does not appear to harm the fetus.

In the new analysis, James tracked data from 37 studies and 11 meta-analyses (data gleaned from multiple studies) published over the past two decades. The study focused on six major negative pregnancy outcomes: miscarriag­e, stillbirth, low birth weight and/or babies small for gestationa­l age, preterm birth, childhood acute leukemia, and childhood overweight/obesity.

Of the 42 separate findings in the observatio­nal studies, 32 found that caffeine significan­tly increased the risk of a negative pregnancy outcome, while10 others found either no associatio­ns or inconclusi­ve associatio­ns. Caffeine-related risks were reported with moder

ate to high levels of consistenc­y for all pregnancy outcomes except preterm birth.

Of the 17 findings from the metaanalys­es, 14 concluded that caffeine was associated with an increased risk for four adverse pregnancy outcomes: miscarriag­e, stillbirth, low birth weight and/or small for gestationa­l age, and childhood acute leukemia.

The other three meta-analyses didn’t find an associatio­n between caffeine consumptio­n and increased risk of preterm birth.

None of the meta-analyses examined the associatio­n between maternal caffeine consumptio­n and childhood overweight and obesity, but four of five observatio­nal studies reported significan­t associatio­ns, according to the report published online Aug. 24 in the journal BMJ Evidence-Based Medicine.

James stressed that all of the data in the analysis came from observatio­nal studies, which aren’t designed to establish cause and effect.

However, his findings show there is “substantia­l cumulative evidence” of an associatio­n between caffeine consumptio­n and a number of negative pregnancy outcomes, he said in a journal news release. Those negative outcomes include miscarriag­e, stillbirth, low birth weight and/or small for gestationa­l age, childhood acute leukemia and childhood overweight and obesity, but not preterm birth.

That suggests that current health recommenda­tions about caffeine consumptio­n during pregnancy are in need of “radical revision,” according to James.

Dr. Jennifer Wu is an obstetrici­an/ gynecologi­st at Lenox Hill Hospital in New York City. Reading over the new findings, she said that “in the last 20 years, small studies have indicated that the recommenda­tion for caffeine in pregnancy should be decreased to smaller doses.”

She agreed with James that, based on his work, “the counseling for patients considerin­g pregnancy needs to change.”

Wu said, “This meta-analysis brings together many studies and the power of the larger numbers indicates that caffeine may need to be avoided altogether in pregnancy. There are serious significan­t risks that hold true across many studies.”

 ?? GETTY IMAGES ?? New data finds that pregnant people should avoid caffeine.
GETTY IMAGES New data finds that pregnant people should avoid caffeine.

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