MedicalResearch.com Interview with : Verena Sengpiel, researcher
Institute of Clinical Sciences, Sahlgrenska Academy
University of Gothenburg
MedicalResearch.com: What are the main findings of the study?
1. Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with the risk of spontaneous preterm delivery.
2. Caffeine intake was consistently associated with decreased birth weight and increased odds of SGA (small for gestational age). This might have clinical implications as even caffeine consumption below the recommended maximum (200 mg/d in the Nordic countries and USA, 300 mg/d according to WHO) was associated with increased risk for SGA.
MedicalResearch.com: Were any of the findings unexpected?
Response: Our findings regarding birth weight and SGA risk were not unexpected, they are consistent with findings from other groups like the CARE study group or Bracken et al, moreover with comparable effect size of a decrease in birth weight by 60-70 g for > 200mg/d or 28 g for 100 mg/d caffeine consumption.
The value of our study lies in the big sample size and comprehensive study design that accounts for many of the challenges and shortcomings in earlier publications.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: As this is an observational study, we cannot conclude that caffeine causes the increase in SGA but we see a robust association. On the other hand it is unlikely that anybody really will succeed in doing a randomized controlled trial on the topic and caffeine is not a substance we do need to consume (like e.g. some medications).
Pregnant women should be informed about our finding so that they can choose to pause their caffeine consumption while pregnant, especially if they actually don’t have problems in doing so. Otherwise, pregnant women should at least follow the official recommendations of less than 2 cups coffee/day.
MedicalResearch.com:What recommendations do you have for future research as a result of this study?
Response: The only way to really solve this matter would be a randomized controlled trial that would be difficult to design with regards to compliance as well as nausea and caffeine aversion during pregnancy.
Further research could concentrate on the patho-mechanism of how caffeine interacts with maternal and fetal metabolism.
We are currently planning a follow-up study for the children born SGA in our study population.
Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study
Verena Sengpiel, Elisabeth Elind, Jonas Bacelis, Staffan Nilsson, Jakob Grove, Ronny Myhre, Margaretha Haugen, Helle M Meltzer, Jan Alexander, Bo Jacobsson, Anne-Lise Brantsaeter BMC Medicine 2013, 11:42 (19 February 2013)