Evaluation of the reproductive and developmental risks of caffeine

Abstract

A risk analysis of in utero caffeine exposure is presented utilizing epidemiological studies and animal studies dealing with congenital malformation, pregnancy loss, and weight reduction. These effects are of interest to teratologists, because animal studies are useful in their evaluation. Many of the epidemiology studies did not evaluate the impact of the “pregnancy signal,” which identifies healthy pregnancies and permits investigators to identify subjects with low pregnancy risks. The spontaneous abortion epidemiology studies were inconsistent and the majority did not consider the confounding introduced by not considering the pregnancy signal. The animal studies do not support the concept that caffeine is an abortafacient for the wide range of human caffeine exposures. Almost all the congenital malformation epidemiology studies were negative. Animal pharmacokinetic studies indicate that the teratogenic plasma level of caffeine has to reach or exceed 60 µg/ml, which is not attainable from ingesting large amounts of caffeine in foods and beverages. No epidemiological study described the “caffeine teratogenic syndrome.” Six of the 17 recent epidemiology studies dealing with the risk of caffeine and fetal weight reduction were negative. Seven of the positive studies had growth reductions that were clinically insignificant and none of the studies cited the animal literature. Analysis of caffeine's reproductive toxicity considers reproducibility and plausibility of clinical, epidemiological, and animal data. Moderate or even high amounts of beverages and foods containing caffeine do not increase the risks of congenital malformations, miscarriage or growth retardation. Pharmacokinetic studies markedly improve the ability to perform the risk analyses. Birth Defects Res (Part B) 92:152–187, 2011. © 2011 Wiley-Liss, Inc.

Position of the Academy of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy Pregnancy Outcome

“…However, birth defects research indicates moderate or high amounts of beverages and foods containing caffeine do not increase the risk of congenital malformations, miscarriage, preterm birth, or growth retardation. 36 Hydration and water needs. Adequate hydration is essential to healthy pregnancy, as a woman accumulates 6 to 9 liters of water during gestation.…”

Age-Dependent Effect of High Caffeine Exposure on Bone and Reproductive Organ

“…Indeed, 28 to 34% of adolescents and young adults have been reported as regular consumers of energy drinks [2]. Most of energy drinks contain 3 to 5 times greater than those in usual soft drinks [3] and some of them contains up to 505mg of caffeine per one serving [4]. Although there is no exact safe dose of caffeine, less than 100 mg/day and 400mg/day for adolescents [3] and healthy adults, respectively, is considered safe [5].…”

“…Most of energy drinks contain 3 to 5 times greater than those in usual soft drinks [3] and some of them contains up to 505mg of caffeine per one serving [4]. Although there is no exact safe dose of caffeine, less than 100 mg/day and 400mg/day for adolescents [3] and healthy adults, respectively, is considered safe [5]. Given that the reports of average consumption of energy drinks among adolescents and young adults and caffeine contents in energy drink, they are easily in danger of exposing above their recommended dose [6].…”

“…It has been reported that maternal caffeine exposures increase fetal loss and low birth weight [3], as well as lower testosterone…”

Does Nausea and Vomiting of Pregnancy Play a Role in the Association Found Between Maternal Caffeine Intake and Fetal Growth Restriction?

“…Indeed, a recent review has stressed the importance of examining the 'pregnancy signal i.e. a reduction to coffee consumption and aversion to other odours and tastes [28]. Therefore the results of the CARE study warranted further investigation of the relationship between fetal growth restriction, nausea and vomiting of pregnancy, maternal caffeine intake and metabolism.…”