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ARTICLE |

Caffeine Use During Pregnancy: How Much Is Safe? FREE

Brenda Eskenazi, PhD; Laura Fenster, PhD; Shanna Swan, PhD; Steven J. Samuels, PhD
JAMA. 1993;270(1):47-47. doi:10.1001/jama.1993.03510010052025
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To the Editor.  —The article by Mills et al1 is one of the first prospective evaluations of the relationship of caffeine use and reproductive outcomes and, thus, is an important contribution to the field. However, we have concerns about the authors' conclusions.First, the results of this study are inconsistent with many of the findings previously reported. Nine of 12 studies representing a variety of populations and study designs found a relationship between maternal caffeine consumption and low birth weight or intrauterine growth retardation (IUGR), although the evidence for the relationship of caffeine and spontaneous abortion (SAB) is less consistent.2 Both decreased birth weight and an increase in SAB have been reported in monkeys consuming caffeine in drinking water at concentrations within the range of human exposure.3 There are a number of biologically plausible mechanisms for caffeine to adversely affect both of these end points, eg, vasoconstriction

REFERENCES

Mills JL, Holmes LB, Aarons JH, et al.  Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation. JAMA . 1993;;269:593-597.
Dlugosz L, Bracken MB.  Reproductive effects of caffeine: a review and theoretical analysis. Epidemiol Rev . 1992;;14:83-100.
Gilbert SG, Rice DC, Reuhi KR, et al.  Adverse pregnancy outcome in the monkey (Macaca fascicularis) after chronic caffeine exposure. J Pharmacol Exp Ther . 1988;; 245:1048-1053.

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Mills JL, Holmes LB, Aarons JH, et al.  Moderate caffeine use and the risk of spontaneous abortion and intrauterine growth retardation. JAMA . 1993;;269:593-597.
Dlugosz L, Bracken MB.  Reproductive effects of caffeine: a review and theoretical analysis. Epidemiol Rev . 1992;;14:83-100.
Gilbert SG, Rice DC, Reuhi KR, et al.  Adverse pregnancy outcome in the monkey (Macaca fascicularis) after chronic caffeine exposure. J Pharmacol Exp Ther . 1988;; 245:1048-1053.
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