Does maternal caffeine consumption, even in small amounts, result in an adverse effect on child growth?
Caffeine exposure during pregnancy, including levels below current clinically recommended guidelines, is associated with shorter stature in early childhood with current evidence available through 8 years of age.
Recent evidence supports a significant association between maternal caffeine consumption during pregnancy, even at levels less than currently recommended (maximum intake of 200 mg/day), with decreased fetal growth. It is uncertain, however, if smaller neonatal anthropometry found at birth persists into childhood. These investigators analyzed data obtained from 2 separate cohort studies composed of mother-child pairs with exposure to low-dose caffeine (median intake < 50 mg/day [half cup/day]; n = 788) and high-dose caffeine (median 200 mg/day [2 cups/day]; n = 1622). Maternal sample collections occurred prior to 20-weeks' gestation. Multiple adjustments occurred for potential confounders, including maternal age, parity, socioeconomic status, smoking, study site, self-reported race and ethnicity, and partner status. Data from the study participants were divided into quartiles (low-dose study) and quintiles (high-dose study) based on the amount of caffeine consumption in each pregnancy cohort. Overall, the investigators found higher caffeine and paraxanthine (the main metabolite of caffeine) concentrations to be significantly associated with shorter childhood stature up to 8 years of age across both maternity-child cohorts. Height and weight scores were significantly lower in the fourth quartile compared with the first quartile in the low-dose study, with average height and weight differences of 1.2 cm and 1.1 kg at 7 years of age. No significant differences in body mass index scores occurred in either group. Outcomes did not vary by child sex.
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Professor of Family Medicine, UNC Chapel Hill