Spontaneous abortion in a hospital population: Are tobacco and coffee intake risk factors? Article DOI:
Cite this article as: Domínguez-Rojas, V., de Juanes-Pardo, J.R., Astasio-Arbiza, P. et al. Eur J Epidemiol (1994) 10: 665. doi:10.1007/BF01719278 Abstract
The objective of this study was to examine the possible relationships between spontaneous abortion and caffeine, tobacco and alcohol intake in a well-controlled group of hospital workers. A retrospective cohort study design including 711 women, 20 to 41 years old, was used. All data regarding the purpose of this study were extracted from clinical histories registered at the Preventive Medicine Service. The dependent variable was spontaneous abortion and the independent variables were tobacco, coffee, and alcohol intake. Age, previous spontaneous abortion, menarcheal age and marital status were considered as potential confounders. The data were analyzed by multiple logistic regression. The following adjusted odds ratios of spontaneous abortion by caffeine consumption were calculated: 141–280 mg/day, 2.20 (1.22–3.96); 281–420 mg/day, 4.81 (2.28–10.14) and 421 or more, 15.43 (7.38–32.43);
p<0.05. The adjusted odds ratio for tobacco were 11 or more cigarettes/day, 3.35 (1.65–6.92); p<0.05. It appears from this and other papers that tobacco and caffeine intake must be considered as clear risk factors for spontaneous abortion or miscarriage. Key words Alcohol consumption Coffee consumption Hospital workers Logistic regression Miscarriage Spontaneous abortion Tobacco smoking References
World Health Organization. Aborto espontáneo y provocado Servicio de informes t écnicos 1970; 461: 5–55.
Wilcox AJ, Weinberg CR, Baird DD. Risk factors for early pregnancy loss. Epidemiology 1990; 1: 382–385.
Edmons DK, Lindsay KS, Miller J. Early embryonic mortality in women. Fertil Steril 1982; 38: 447–451.
Miller JF, Williamson E. Fetal loss following implantation: A prospective study. Lancet 1980 (i): 554–557.
Domínguez-Rojas V, Calle ME, Ortega P, Astasio P, Valero J, del Rey Calero J. Abordaje epidemiológico del aborto espontáneo. Estudio de factores obstétricos y ginecológicos. Toko-Gin Práct 1990; 49 (5): 265–270.
Domínguez-Rojas V, Calle ME, Ortega P, Astasio P, Valero J, del Rey Calero J. Adjusting risk factors in spontaneous abortion by multiple logistic regression. Eur J Epidemiol 1991; 7: 171–174.
Gustavii B. Miscarriage rate in women aged 35 years or more. Contr Gynec Obstet 1986; 15: 45–49.
Triolo O, Stella NC, Dugo C, Corrado F. Abortivita spontanea ed eta materna avanzata. Minerva Ginecol 1990; 42 (9): 345–346.
Reginald PW, Beard RW, Chappie J, Forbes PB, Liddell HS, Mowbray JF, Underwood JL. Outcome of pregnancies progressing beyond 28 weeks gestation in women with a history of recurrent miscarriage. Br J Obstet Gynaecol 1987; 94: 643–648.
Stirrat GM. Recurrent miscarriage II: Clinical associations, causes and management. Lancet 1990; 336: 728–733.
Hatch MC, Warburton D, Santella RM. Polycyclic aromatic hydrocarbon-DNA adducts in spontaneously aborted fetal tissue. Carcinogenesis 1990; 11 (9): 1673–1675.
Lakagos SW, Wessen BJ, Zelen M. An analysis of contaminated well water and health effects in Woburn, Massachusetts. J Am Statist Ass 1986; 81: 583–596.
Murphy MJ, Graziano JH, Popovac D, et al. Past pregnancy outcomes among women living in vicinity of a lead smelter in Kosovo, Yugoslavia. Am J Pub Health 1990; 80: 33–35.
Ulstein M, Jensen TS, Irgens LM, Sivertsen E. Outcome of pregnancy in one Norwegian county 3 years prior to and 3 years subsequent to the Chernobyl accident. Acta Obstet Gynecol Scand 1990; 69 (4): 277–280.
Anokute CC. Epidemiology of spontaneous abortions: The effects of alcohol consumption and cigarette smoking. J Nat Med Assoc 1986; 78: 771–775.
Fenster L, Eskenazi B, Windham GC, Swan SH. Caffeine consumption during pregnancy and spontaneous abortion. Epidemiology 1991; 2 (3): 168–174.
Fox SH, Brown C, Koontz AM, Kessel SS. Perceptions of risk of smoking and heavy drinking during pregnancy: 1985 NHIS findings. Pub Health Rep 1987; 102 (1): 73–79.
Furuhashi N, Sato S, Suzuki M, Hiruta M, Tanaka M, Takahashi T. Effects of caffeine ingestion during pregnancy. Gynecol Obstet Invest 1985; 19: 187–191.
Kline J, Stein ZA, Susser M, Warburton D. Smoking: A risk factor for spontaneous abortion. N Engl J Med 1977; 197 (15): 793–796.
Narod SA, De Sanjose S, Victoria C. Coffee during pregnancy: a reproductive hazard?. Am J Obstet Gynecol 1991; 164: 1109–1114.
Srisuphan W, Bracken MB. Caffeine consumption during pregnancy and association with late spontaneous abortion. Am J Obstet Gynecol 1986; 154 (1): 14–20.
Schlesselman JJ, Stolley PD. Sources of bias. In: Case-control studies: design, conduct, analysis. New York, Oxford University Press, 1982: 124–143.
Kleinbaum DC, Kupper LL, Morgenstern H. Information bias. In: Epidemiologic research. Principles and quantitative methods. New York: Van Nostrand Reinhold, 1982: 220–241.
Quatro PRO. Borland. Scotts Valley, CA, USA, 1990.
Statistix version 3.1. Analytical Software. St Paul, MN, USA.
Campos-Filho N, Franco EL. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods. Am J Epidemiol 1989; 129: 439–444.
Parazzini F, Bocciolone L, La Vecchia C, Negri C. Maternal and paternal moderate daily alcohol consumption and unexplained miscarriage. Int J Epidemiol 1990; 97: 618–622.
Marrison KL, Breen TM, Hennessey JF. The effect of patient smoking habit on the outcome of IVF and GIFT treatment. Aust N Z J Obstet Gynaecol 1990; 30 (4): 340–342.
Parazzini F, Bocciolone L, La Vecchia C, Negri C, Acaia B. Risk factors for spontaneous abortion. Int J Epidemiol 1991; 20 (1): 157–161.
Luck W, Nau H. Exposure of the fetus, neonate and nursed infant to nicotine and cotinine from maternal smoking. N Engl J Med 1984; 311: 672–675.
Watkinson B, Fried PA. Maternal caffeine use before, during and after pregnancy: Effects upon offspring. Neurobehav Tox Teratol 1985; 7: 9–17.
Benowitz NL. Clinical pharmacology of caffeine. Ann Rev Med 1990; 40: 277–288.
Knutt R, Rotheweiller H, Schlatter C. The effect of pregnancy on the pharmacokinetics of caffeine. Arch Toxicol Suppl. 1982: 185–192.
Elmazar MMA, McElhatton PR, Sullivan FM. Studies on the teratogenic effects of different preparations of caffeine in mice. Toxicology 1982; 23: 57.
Rall TW. Drogas utilizadas en el tratamiento del asma. Las metilxantinas, el cromoglicolato disódico y otros agentes. In: Las bases farmacológicas de la terapéutica. Goodman-Gillman A, Rall TW. Panam éricana 1991: 605–623.
Benowitz NL, Hall SM, Modin G. Persistent increase in caffeine concentrations in people who stop smoking. Br Med J 1989; 298: 1075–1076.
Gilbert SG, Rice DG, Reuhl KR, Stavric B. Adverse pregnancy outcome in the monkey
after chronic caffeine exposure. J Pharmacol Exper Ther 1988; 245: 1048–1053.
Casas M, Ferrer S, Calaf J, Rodríguez-Espinosa J, Jane F. Dopaminergic mechanism for caffeine-induced decrease in fertility? Lancet 1989; 4: 731.
Christianson RE, Oechsli FW. Caffeinated beverages and decrease of fertility. Letter to editor. Lancet 1989; Feb, 18: 378.
Google Scholar Copyright information
© Kluwer Academic Publishers 1994