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Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: a meta-analysis

1998; Elsevier BV; Volume: 12; Issue: 4 Linguagem: Inglês

10.1016/s0890-6238(98)00024-0

1873-1708

Olavo Fernandes, Mona Sabharwal, Tom Smiley, Anne Pastuszak, Gideon Koren, Thomas R. Einarson,

Per- and polyfluoroalkyl substances research

The objective was to determine the association of moderate to heavy caffeine consumption during pregnancy on spontaneous abortion and birth weight in humans. Data sources used included a computerized literature search of MEDLINE (1966–July 1996); EMBASE (1988–November 1996); Psychlit I (1974–1986); Psychlit II (1987–1996); CINAHL (1982–May 1996) and manual search of bibliographies of pertinent articles. Inclusion criteria were: English language research articles; pregnant human females; case control or cohort design; documented quantity of caffeine consumption during pregnancy; control group with minimal or no caffeine consumption (0 to 150 mg caffeine/d); documented data regarding spontaneous abortion and/or fetal growth. The exclusion criteria were: case reports; editorials; review papers. The methods section of each study was examined independently by two blinded investigators with a third investigator adjudicating disagreements. Two independent investigators extracted data onto a standardized form. A third investigator adjudicated discrepancies. We compared a caffeine-exposed group (>150 mg/d) and controls (0 to 150 mg/d), using Mantel–Haenszel pooling. Of the 32 studies meeting inclusion criteria, 12 had extractable data (6 for spontaneous abortion, 7 for low birth weight, 1 common study). Mantel–Haenszel odds ratio (CI95%) was 1.36 (1.29–1.45) for spontaneous abortion in 42,988 pregnancies. The overall risk ratio was 1.51 (1.39–1.63) for low birthweight ( 150 mg caffeine per d. A possible contribution to these results of maternal age, smoking, ethanol use, or other confounders could not be excluded.