Pre-pregnancy caffeine and caffeinated beverage intake and risk of spontaneous abortion

Abstract

Purpose

To investigate the relation between pre-pregnancy caffeine and caffeinated beverage intake and risk of spontaneous abortion (SAB).

Methods

Our prospective cohort study included 15,590 pregnancies from 11,072 women with no history of SAB in the Nurses’ Health Study II (1991–2009). Beverage intake was assessed every 4 years using a validated questionnaire. Pregnancies were self-reported with case pregnancies lost spontaneously at <20 weeks gestation. Multivariable log-binomial regression models with generalized estimating equations were used to estimate the relative risks (RRs) and 95 % confidence intervals (CIs).

Results

There was a positive linear trend across categories of pre-pregnancy caffeine intake and risk of SAB such that women consuming >400 mg/day had 1.11 (95 % CI 0.98, 1.25) times the risk of SAB compared to women consuming <50 mg/day (p trend = 0.05). Total coffee intake had a positive, linear association with SAB. Compared to women with no pre-pregnancy coffee intake, women consuming ≥4 servings/day had a 20 % (6, 36 %) increased risk of SAB (p trend = 0.01). There was no difference in the association between caffeinated and decaffeinated coffee and risk of SAB. Pre-pregnancy intake of caffeinated tea, caffeinated soda, and decaffeinated soda had no association with SAB.

Conclusions

Pre-pregnancy coffee consumption at levels ≥4 servings/day is associated with increased risk of SAB, particularly at weeks 8–19.

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References

  1. 1.

    Greenwood DC, Thatcher NJ, Ye J, Garrard L, Keogh G, King LG, Cade JE (2014) Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 29(10):725–734

    CAS  Article  Google Scholar 

  2. 2.

    Fenster L, Hubbard AE, Swan SH, Windham GC, Waller K, Hiatt RA, Benowitz N (1997) Caffeinated beverages, decaffeinated coffee, and spontaneous abortion. Epidemiology 8(5):515–523

    CAS  Article  Google Scholar 

  3. 3.

    Infante-Rivard C, Fernandez A, Gauthier R, David M, Rivard GE (1993) Fetal loss associated with caffeine intake before and during pregnancy. JAMA 270(24):2940–2943

    CAS  Article  Google Scholar 

  4. 4.

    Axelsson G, Rylander R, Molin I (1989) Outcome of pregnancy in relation to irregular and inconvenient work schedules. Br J Ind Med 46(6):393–398

    CAS  Google Scholar 

  5. 5.

    Savitz DA, Chan RL, Herring AH, Howards PP, Hartmann KE (2008) Caffeine and miscarriage risk. Epidemiology 19(1):55–62 b9

    Article  Google Scholar 

  6. 6.

    Wen W, Shu XO, Jacobs DR Jr, Brown JE (2001) The associations of maternal caffeine consumption and nausea with spontaneous abortion. Epidemiology 12(1):38–42

    CAS  Article  Google Scholar 

  7. 7.

    Pollack AZ, Buck Louis GM, Sundaram R, Lum KJ (2010) Caffeine consumption and miscarriage: a prospective cohort study. Fertil Steril 93(1):304–306

    CAS  Article  Google Scholar 

  8. 8.

    Wilcox AJ, Weinberg CR, Baird DD (1990) Risk factors for early pregnancy loss. Epidemiology 1(5):382–385

    CAS  Article  Google Scholar 

  9. 9.

    Tolstrup JS, Kjaer SK, Munk C, Madsen LB, Ottesen B, Bergholt T, Gronbaek M (2003) Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion? Hum Reprod 18(12):2704–2710

    CAS  Article  Google Scholar 

  10. 10.

    Hahn KA, Wise LA, Rothman KJ, Mikkelsen EM, Brogly SB, Sorensen HT, Riis AH, Hatch EE (2015) Caffeine and caffeinated beverage consumption and risk of spontaneous abortion. Hum Reprod 30(5):1246–1255

    CAS  Article  Google Scholar 

  11. 11.

    Fulgoni VL 3rd, Keast DR, Lieberman HR (2015) Trends in intake and sources of caffeine in the diets of US adults: 2001–2010. Am J Clin Nutr 101(5):1081–1087

    CAS  Article  Google Scholar 

  12. 12.

    Finer LB, Zolna MR (2014) Shifts in intended and unintended pregnancies in the United States, 2001–2008. Am J Public Health 104(Suppl 1):S43–S48

    Article  Google Scholar 

  13. 13.

    Dott M, Rasmussen SA, Hogue CJ, Reefhuis J (2010) Association between pregnancy intention and reproductive-health related behaviors before and after pregnancy recognition, National Birth Defects Prevention Study, 1997–2002. Matern Child Health J 14(3):373–381

    Article  Google Scholar 

  14. 14.

    Mohllajee AP, Curtis KM, Morrow B, Marchbanks PA (2007) Pregnancy intention and its relationship to birth and maternal outcomes. Obstet Gynecol 109(3):678–686

    CAS  Article  Google Scholar 

  15. 15.

    Willett WC, Lenart E (1998) Chapter 6: Reproducibility and validity of Food Frequency Questionnaires. In: Willett WC (ed) Nutritional Epidemiology, 2nd edn. Oxford University Press, New York, New York

    Google Scholar 

  16. 16.

    Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135(10):1114–1126 (discussion 1127-1136)

    CAS  Article  Google Scholar 

  17. 17.

    U.S. department of agriculture agricultural research service (2012) USDA National nutrient database for standard reference, Release 25. http://www.ars.usda.gov/ba/bhnrc/ndl

  18. 18.

    Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B, Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18(4):858–867

    CAS  Article  Google Scholar 

  19. 19.

    Olson JE, Shu XO, Ross JA, Pendergrass T, Robison LL (1997) Medical record validation of maternally reported birth characteristics and pregnancy-related events: a report from the children’s cancer Group. Am J Epidemiol 145(1):58–67

    CAS  Article  Google Scholar 

  20. 20.

    Wilcox AJ, Horney LF (1984) Accuracy of spontaneous abortion recall. Am J Epidemiol 120(5):727–733

    CAS  Article  Google Scholar 

  21. 21.

    Kristensen P, Irgens LM (2000) Maternal reproductive history: a registry based comparison of previous pregnancy data derived from maternal recall and data obtained during the actual pregnancy. Acta Obstet Gynecol Scand 79(6):471–477

    CAS  Article  Google Scholar 

  22. 22.

    Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, Willett WC (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1(6):466–473

    CAS  Article  Google Scholar 

  23. 23.

    Wolf AM, Hunter DJ, Colditz GA, Manson JE, Stampfer MJ, Corsano KA, Rosner B, Kriska A, Willett WC (1994) Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 23(5):991–999

    CAS  Article  Google Scholar 

  24. 24.

    Durrleman S, Simon R (1989) Flexible regression models with cubic splines. Stat Med 8(5):551–561

    CAS  Article  Google Scholar 

  25. 25.

    Weinberg CR (1993) Toward a clearer definition of confounding. Am J Epidemiol 137(1):1–8

    CAS  Article  Google Scholar 

  26. 26.

    Howards PP, Schisterman EF, Heagerty PJ (2007) Potential confounding by exposure history and prior outcomes: an example from perinatal epidemiology. Epidemiology 18(5):544–551

    Article  Google Scholar 

  27. 27.

    Kost K, Forrest JD (1995) Intention status of U.S. births in, differences by mothers’ socioeconomic and demographic characteristics. Fam Plann Perspect 27(1):11–17

    CAS  Article  Google Scholar 

  28. 28.

    Glei DA (1999) Measuring contraceptive use patterns among teenage and adult women. Fam Plann Perspect 31(2):73–80

    CAS  Article  Google Scholar 

  29. 29.

    Chen LW, Wu Y, Neelakantan N, Chong MF, Pan A, van Dam RM (2016) Maternal caffeine intake during pregnancy and risk of pregnancy loss: a categorical and dose-response meta-analysis of prospective studies. Public Health Nutr 19(7):1233–1244

    Article  Google Scholar 

  30. 30.

    Lawson CC, LeMasters GK, Wilson KA (2004) Changes in caffeine consumption as a signal of pregnancy. Reprod Toxicol 18(5):625–633

    CAS  Article  Google Scholar 

  31. 31.

    Cnattingius S, Signorello LB, Anneren G, Clausson B, Ekbom A, Ljunger E, Blot WJ, McLaughlin JK, Petersson G, Rane A, Granath F (2000) Caffeine intake and the risk of first-trimester spontaneous abortion. N Engl J Med 343(25):1839–1845

    CAS  Article  Google Scholar 

  32. 32.

    Hook EB (1978) Dietary cravings and aversions during pregnancy. Am J Clin Nutr 31(8):1355–1362

    CAS  Article  Google Scholar 

  33. 33.

    Ludwig IA, Clifford MN, Lean ME, Ashihara H, Crozier A (2014) Coffee: biochemistry and potential impact on health. Food Funct 5(8):1695–1717

    CAS  Article  Google Scholar 

  34. 34.

    Lawson CC, LeMasters GK, Levin LS, Liu JH (2002) Pregnancy hormone metabolite patterns, pregnancy symptoms, and coffee consumption. Am J Epidemiol 156(5):428–437

    Article  Google Scholar 

  35. 35.

    Kotsopoulos J, Eliassen AH, Missmer SA, Hankinson SE, Tworoger SS (2009) Relationship between caffeine intake and plasma sex hormone concentrations in premenopausal and postmenopausal women. Cancer 115(12):2765–2774

    CAS  Article  Google Scholar 

  36. 36.

    Sisti JS, Hankinson SE, Caporaso NE, Gu F, Tamimi RM, Rosner B, Xu X, Ziegler R, Eliassen AH (2015) Caffeine, coffee, and tea intake and urinary estrogens and estrogen metabolites in premenopausal women. Cancer Epidemiol Biomarkers Prev 24(8):1174–1183

    CAS  Article  Google Scholar 

  37. 37.

    Butler MA, Iwasaki M, Guengerich FP, Kadlubar FF (1989) Human cytochrome P-450PA (P-450IA2), the phenacetin O-deethylase, is primarily responsible for the hepatic 3-demethylation of caffeine and N-oxidation of carcinogenic arylamines. Proc Natl Acad Sci USA 86(20):7696–7700

    CAS  Article  Google Scholar 

  38. 38.

    Lee AJ, Cai MX, Thomas PE, Conney AH, Zhu BT (2003) Characterization of the oxidative metabolites of 17beta-estradiol and estrone formed by 15 selectively expressed human cytochrome p450 isoforms. Endocrinology 144(8):3382–3398

    CAS  Article  Google Scholar 

  39. 39.

    Djordjevic N, Ghotbi R, Bertilsson L, Jankovic S, Aklillu E (2008) Induction of CYP1A2 by heavy coffee consumption in Serbs and Swedes. Eur J Clin Pharmacol 64(4):381–385

    CAS  Article  Google Scholar 

  40. 40.

    Vakharia DD, Liu N, Pause R, Fasco M, Bessette E, Zhang QY, Kaminsky LS (2001) Effect of metals on polycyclic aromatic hydrocarbon induction of CYP1A1 and CYP1A2 in human hepatocyte cultures. Toxicol Appl Pharmacol 170(2):93–103

    CAS  Article  Google Scholar 

  41. 41.

    Zhu BT, Wang P, Nagai M, Wen Y, Bai HW (2009) Inhibition of human catechol-O-methyltransferase (COMT)-mediated O-methylation of catechol estrogens by major polyphenolic components present in coffee. J Steroid Biochem Mol Biol 113(1–2):65–74

    CAS  Article  Google Scholar 

  42. 42.

    Bracken MB, Triche E, Grosso L, Hellenbrand K, Belanger K, Leaderer BP (2002) Heterogeneity in assessing self-reports of caffeine exposure: implications for studies of health effects. Epidemiology 13(2):165–171

    Article  Google Scholar 

  43. 43.

    Frary CD, Johnson RK, Wang MQ (2005) Food sources and intakes of caffeine in the diets of persons in the United States. J Am Diet Assoc 105(1):110–113

    Article  Google Scholar 

  44. 44.

    Gaskins AJ, Rich-Edwards JW, Colaci DS, Afeiche MC, Toth TL, Gillman MW, Missmer SA, Chavarro JE (2014) Prepregnancy and early adulthood body mass index and adult weight change in relation to fetal loss. Obstet Gynecol 124(4):662–669

    Article  Google Scholar 

  45. 45.

    Gaskins AJ, Rich-Edwards JW, Hauser R, Williams PL, Gillman MW, Ginsburg ES, Missmer SA, Chavarro JE (2014) Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth. Obstet Gynecol 124(1):23–31

    CAS  Article  Google Scholar 

  46. 46.

    The American Congress of Obstetricia ns and Gynecologists (ACOG) Committee Opinion No. 462 (2010) Moderate caffeine consumption during pregnancy. Obstet Gynecol 116(2 Pt 1):467–468

    Google Scholar 

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Correspondence to Audrey J. Gaskins.

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Gaskins, A.J., Rich-Edwards, J.W., Williams, P.L. et al. Pre-pregnancy caffeine and caffeinated beverage intake and risk of spontaneous abortion. Eur J Nutr 57, 107–117 (2018). https://doi.org/10.1007/s00394-016-1301-2

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Keywords

  • Caffeine
  • Coffee
  • Miscarriage
  • Pregnancy
  • Spontaneous abortion