Caffeine intake during pregnancy and adverse birth outcomes: a systematic review and dose-response meta-analysis
Greenwood DC, Thatcher NJ, Ye J, Garrard L, Keogh G, King LG, Cade JE
European journal of epidemiology · 90 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2014-09-01 · Eur J Epidemiol · vol. 29 · número 10 · págs. 725–734
- Editorial
- Springer Science+Business Media
- Citado
- 150 citas · más que el 90% de estudios similares · 2.5× el promedio de su campo
- Referencias
- 60 trabajos
- Acceso
- De pago
- Áreas de investigación
- Coffee research and impacts · Prenatal Substance Exposure Effects · Pregnancy and Medication Impact
- Palabras clave
- caffeine consumption, pregnancy, birth outcomes, miscarriage, stillbirth, preterm birth, low birth weight, small for gestational age, dose-response relationship, placental transfer
- MeSH
- humans, abortion, spontaneous, premature birth, birth weight, caffeine, pregnancy outcome, risk, pregnancy, infant, small for gestational age, female, stillbirth
7 autores
- Darren Charles Greenwood🇬🇧 · autor de correspondenciaUniversity of Leeds
- Natalie J Thatcher🇬🇧Food Standards Agency
- Jin Ye🇬🇧University of Leeds
- Lucy Garrard🇬🇧University of Leeds
- Georgina Keogh🇬🇧University of Leeds
- Laura G. King🇬🇧University of Leeds
- Janet Elizabeth Cade🇬🇧University of Leeds
Resumen
El texto original del estudio, en el idioma en que se publicó.
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.
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