Associations of maternal caffeine intake with birth outcomes: results from the Lifeways Cross Generation Cohort Study

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ABSTRACT

Background

Maternal caffeine intake is associated with adverse birth outcomes, but in most studies the primary caffeine source is coffee; the influence of tea caffeine remains unclear.

Objective

The aim of the study was to examine the association between maternal caffeine intake and birth outcomes in a population with tea as the predominant caffeine source.

Design

Data from 941 Irish mother-child pairs of the Lifeways Cross Generation Cohort Study were examined. Maternal dietary intakes in early pregnancy were assessed using a validated food-frequency questionnaire. Caffeine intake was derived from coffee, tea, soft drinks, and cocoa-containing foods and beverages. Associations of maternal caffeine intake with continuous (birth weight, birth length, and gestational age) and binary [low birth weight (LBW) (<2500 g) and preterm birth (PB) (<37 wk gestational age)] birth outcomes were investigated using multiple linear and logistic regressions, respectively, with adjustment for potential confounders.

Results

Tea was the predominant caffeine source (48%), followed by coffee (39%). In the fully adjusted model, maternal caffeine intake was associated with lower birth weight [β (95% CI): −71.9 (−105.4, −38.4) g · 100 mg–1 · d–1 caffeine increment], shorter birth length [−0.30 (−0.49, −0.11) cm], smaller head circumference [−0.12 (−0.24, −0.01) cm], and shorter gestational age [−0.13 (−0.25, −0.02) wk]; higher risks for LBW [OR (95% CI): 1.47 (1.14, 1.90)] and PB [1.36 (1.07, 1.74)] were also observed (all P < 0.05). The associations were robust to the exclusion of participants with pregnancy complications and in never smokers. Similar higher risks of adverse birth outcomes were observed for the highest caffeine intake categories from coffee [ORLBW: 3.10 (1.08, 8.89); ORPB: 2.74 (1.05, 7.16)] and tea [ORLBW: 2.47 (1.02, 6.01); ORPB: 2.56 (1.14, 5.75)], compared with the lowest intake categories (all P < 0.05).

Conclusions

Maternal caffeine intake from both coffee and tea is associated with adverse birth outcomes. This prospective observational study was registered at ISRCTN Registry as ISRCTN16537904.

Key Words

caffeine
coffee
tea
pregnancy
birth outcomes
maternal
birth weight

Abbreviations used

cAMP
cyclic adenosine monophosphate
LBW
low birth weight
PB
preterm birth.

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The Lifeways Cross Generation Cohort Study is funded by the Irish Health Research Board and is overseen by an interdisciplinary steering group. This work was supported by a research grant from the Irish Health Research Board (reference HRC/2007/13). Further support was received through an award by the ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 grant agreement number 696295, with funding provided by Science Foundation Ireland, Ireland (Grant Number SFI/16/ERA-HDHL/3360) and the European Union.