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Caffeine in pregnancy
Results
Comment
Coffee and colorectal cancer
Coffee and stroke in hypertensive non-smokers
Comment
Overall comment
Drinking coffee, or taking in caffeine from tea or cola, or wherever, always seems to be popping up in the newspapers with one message or another, sometimes with conflicting results. So it is comforting that epidemiologists and others are beginning to pull together information so that we can make sense of it. Three recent studies, two of which are meta-analyses, helps us understand the proper place of caffeine, and when to avoid it. It may help formulate better advice for people as part of evidence-based guidance for healthy living.
In interpreting what follows, where data are often analysed in terms of caffeine consumption in milligrams per day, one cup of coffee is equivalent to about 75 mg caffeine, one cup of tea to about 30 mg and one can of cola about 50 mg. But beware espresso or café solo - there the caffeine content can be double at 150 mg a cup!
Caffeine in pregnancy
A meta-analysis examined the effects of caffeine consumption on spontaneous abortion and low birthweight pregnancies [1]. Spontaneous abortion was defined as expulsion from the uterus of products of conception before about 20 weeks (including foetal loss, foetal death and miscarriage). Low birthweight was defined as less than 2,500 g. The control subjects were women who consumed less than 150 mg caffeine a day (two cups of coffee or less), and exposed women those who consumed more than this. Searching was thorough.
Results
In 42,889 women the rate of spontaneous abortion was 24.4% in exposed women, and 20.0% in controls, with consistency between studies (Figure 1).
The number needed to harm we calculated as 23 (Table 1).
Caffeine intake, spontaneous abortion, and low birthweight infants
Number (%) of women affected
Caffeine >150 mg/day
Caffeine <150 mg/day
Relative risk (95%CI)
NNH (95% CI)
Spontaneous abortion
1994/8181 (24.4)
6941/34708 (20.0)
1.27 (1.22 to 1.33)
23 (19 to 30)
Low birthweight infant
713/9308 (7.7)
3033/55383 (5.5)
1.50 (1.39 to 1.62)
46 (36 to 62)
This means that for every 23 pregnant women who consume more than two cups of coffee or six cups of tea a day, one will have a spontaneous abortion who would not have had they not consumed this much caffeine.
In 64,691 women the rate of low birthweight infants was 7.7% in exposed women, and 5.5% in controls, with consistency between studies (Figure 2).
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