Article: Coffee Drinking in Pregnancy
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Heavy Coffee Drinking in Pregnancy Tied to Increased Risk of Fetal Death
By Anne Harding
NEW YORK (Reuters Health) Nov 15 - Fetal death is twice as likely among women who drink eight or more cups of coffee daily during pregnancy compared to women who avoid coffee while pregnant, Danish researchers report.
Adjusting for other risk factors weakened the association somewhat, but heavy coffee drinkers remained at 59% greater risk of fetal death, Dr. Bodil Hammer Bech of the University of Aarhus and colleagues report.
Women who drank four to seven cups daily had a 33% increased risk of fetal death.
"Due to our findings and previous studies we think it is reasonable to apply the precaution principle and advise pregnant women to abstain from drinking more than 3 cups of coffee per day," Dr. Bech told Reuters Health. Denmark currently has an official policy warning women to restrict their coffee intake to three cups or less daily.
While a number of studies have linked coffee drinking to adverse pregnancy outcomes, and there are plausible physiological mechanisms by which caffeine might harm a fetus, the risks of coffee drinking in pregnancy have been questioned, Dr. Bech and colleagues note in the November 15 issue of the American Journal of Epidemiology.
To investigate, they surveyed 88,482 women enrolled in the Danish National Birth Cohort, among whom there were 1,102 fetal deaths. The women were interviewed about coffee intake and potentially confounding factors, such as alcohol consumption and smoking, at approximately 16 weeks' gestation.
Among the women, 55.4% reported drinking no coffee during pregnancy, while 31.4% drank one-half to three cups daily. Thirteen percent of the women drank more than three cups of coffee daily, while 3.4% drank eight or more cups a day.
After adjustment, the researchers found, women who drank one-half to three cups a day had a 3% increased risk of fetal death; those who consumed four to seven cups had a 33% increased risk; and those who drank eight or more cups had a 59% greater risk of fetal death. The association was strongest for fetal deaths after 20 weeks gestation.
The researchers found no link between tea or cola consumption and fetal death, suggesting that caffeine may not be the exposure of interest. "Coffee contains a number of chemical compounds," Dr. Bech noted. "Further studies should try to disentangle a caffeine effect from a non-caffeine effect."
Am J Epidemiol 2005;162:983-990.
