(08-11-10) Caffeine consumption during pregnancy and risk of preterm birth: a meta-analysis1,2,3,4

Ekaterina Maslova, Sayanti Bhattacharya, Shih-Wen Lin and Karin B Michels
1 From the Department of Nutrition, Harvard School of Public Health, Boston, MA (EM); the Institute of Molecular Medicine, University of Texas Health Science Center at Houston, TX (SB); the Cancer Prevention Fellowship Program, National Cancer Institute, National Institutes of Health, Bethesda, MD (S-WL); the Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (KBM); and the Department of Epidemiology, Harvard School of Public Health, Boston, MA (KBM).
2 SB and S-WL contributed equally to this work.
3 There were no funding sources for this work. S-WL was funded by the Cancer Prevention Fellowship Program, National Institutes of Health, Bethesda, MD. SB was funded by a postdoctoral fellowship at the Institute of Molecular Medicine at the University of Texas Health Science Center, Houston, TX.
4 Address correspondence to E Maslova, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Building 2, Boston, MA, 02115. E-mail: [email protected] .
Background: The effect of caffeine intake during pregnancy on the risk of preterm delivery has been studied for the past 3 decades with inconsistent results.
Objective: We performed a meta-analysis examining the association between caffeine consumption during pregnancy and risk of preterm birth.
Design: We searched MEDLINE and EMBASE articles published between 1966 and July 2010, cross-referenced reference lists of the retrieved articles, and identified 15 cohort and 7 case-control studies that met inclusion criteria for this meta-analysis.
Results: The combined odds ratios (ORs) obtained by using fixed-effects models for cohort studies were 1.11 (95% CI: 0.96, 1.28), 1.10 (95% CI: 1.01, 1.19), and 1.08 (95% CI: 0.93, 1.27) for risk of preterm birth comparing the highest with the lowest level of caffeine intake (or no intake) (mg/d) during the first, second, and third trimesters, respectively. Results for the case-control studies yielded no associations for the first (OR: 1.07; 95% CI: 0.84, 1.37), second (OR: 1.17; 95% CI: 0.94, 1.45), or third (OR: 0.94; 95% CI: 0.79, 1.12) trimesters. No overall heterogeneity was found by region, publication decade, exposure and outcome assessment, caffeine sources, or adjustment for confounding, which was largely driven by individual studies.
Conclusion: In this meta-analysis, we observed no important association between caffeine intake during pregnancy and the risk of preterm birth for cohort and case-control studies.

Source: Vol. 92, No. 5, 1120-1132, November 2010 American Journal of Clinical Nutrition

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