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Kukkonen A, Hantunen S, Voutilainen A, Ruusunen A, Backman K, Kirjavainen PV, Ylilauri M, Voutilainen R, Pasanen M, Keski-Nisula L. Maternal caffeine intake during pregnancy and the risk of delivering a small for gestational age baby: Kuopio Birth Cohort. Arch Gynecol Obstet 2024; 310:359-368. [PMID: 38767721 PMCID: PMC11169027 DOI: 10.1007/s00404-024-07538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE High caffeine intake during pregnancy is associated with restricted fetal growth. We aimed to evaluate the association between maternal caffeine intake during early and late pregnancy and the risk of delivering a small for gestational age (SGA) baby. METHODS Kuopio Birth Cohort (KuBiCo) is a prospective cohort study including women whose pregnancies and deliveries were treated at the prenatal clinics in outpatient healthcare centers and in Kuopio University Hospital, Finland. Maternal diet and caffeine intake during the first (n = 2007) and third (n = 4362) trimester of pregnancy were assessed using a 160-item food frequency questionnaire (2013-2022). SGA was defined as birth weight corrected for gestational age below - 2 standard deviations from the mean, according to the sex-specific Finnish fetal growth curves. RESULTS Altogether in 32 and 38% (1st and 3rd trimester) of all women and in 44 and 52% of coffee drinkers, caffeine intake exceeded the recommendation for caffeine intake ( ≤ 200 mg/day) during pregnancy. The women with moderate (51-200 mg/day) (aOR 1.87; 95% CI: 1.16-3.02) and high (> 200 mg/day) (aOR 1.51; 95% CI: 1.08-2.10) caffeine intake during the first trimester were in the highest risk of having an SGA newborn. Caffeine intake in the third trimester of pregnancy was not associated with SGA. CONCLUSIONS Moderate and high caffeine intake during early pregnancy is associated with SGA. As the results suggest that even moderate caffeine intake during the first trimester may increase the risk of SGA, the intake within recommendation limits does not necessarily appear to be safe for pregnant women and their newborns.
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Affiliation(s)
- Anni Kukkonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Anu Ruusunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, IMPACT-the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Australia
| | - Katri Backman
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Pirkka V Kirjavainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Maija Ylilauri
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Pasanen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Leea Keski-Nisula
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
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Osman MMA, Mullins E, Lees C. Assessing cardiovascular benefits of beetroot juice and exercise in women planning to conceive: reply to correspondence. J Hypertens 2024; 42:1287. [PMID: 38818843 DOI: 10.1097/hjh.0000000000003734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Affiliation(s)
| | - Edward Mullins
- Department of Metabolism, Digestion and Reproduction, Imperial College London
- The George Institute for Global Health, London, UK
| | - Christoph Lees
- Department of Metabolism, Digestion and Reproduction, Imperial College London
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Boureka E, Tsakiridis I, Kostakis N, Giouleka S, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Dagklis T. Antenatal Care: A Comparative Review of Guidelines. Obstet Gynecol Surv 2024; 79:290-303. [PMID: 38764206 DOI: 10.1097/ogx.0000000000001261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Importance Antenatal care plays a crucial role in safely monitoring and ensuring the well-being of both the mother and the fetus during pregnancy, ultimately leading to the best possible perinatal outcomes. Objective The aim of this study was to review and compare the most recently published guidelines on antenatal care. Evidence Acquisition A descriptive review of guidelines from the National Institute for Health and Care Excellence, the Public Health Agency of Canada, the World Health Organization, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists regarding antenatal care was conducted. Results There is a consensus among the reviewed guidelines regarding the necessary appointments during the antenatal period, the proper timing for induction of labor, the number and frequency of laboratory examinations for the assessment of mother's well-being, and management strategies for common physiological problems during pregnancy, such as nausea and vomiting, heartburn, pelvic pain, leg cramps, and symptomatic vaginal discharge. In addition, special consideration should be given for mental health issues and timely referral to a specialist, reassurance of complete maternal vaccination, counseling for safe use of medical agents, and advice for cessation of substance, alcohol, and tobacco use during pregnancy. Controversy surrounds clinical evaluation during the antenatal period, particularly when it comes to the routine use of an oral glucose tolerance test and symphysis-fundal height measurement for assessing fetal growth, whereas routine cardiotocography and fetal movement counting are suggested practices only by Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Of note, recommendations on nutritional interventions and supplementation are offered only by Public Health Agency of Canada and World Health Organization, with some minor discrepancies in the optimal dosage. Conclusions Antenatal care remains a critical factor in achieving positive outcomes, but there are variations depending on the socioeconomic status of each country. Therefore, the establishment of consistent international protocols for optimal antenatal care is of utmost importance. This can help provide safe guidance for healthcare providers and, consequently, improve both maternal and fetal outcomes.
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Affiliation(s)
| | | | | | | | | | - Ioannis Kalogiannidis
- Associate Professor, Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sonestedt E, Lukic M. Beverages - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10458. [PMID: 38571923 PMCID: PMC10989231 DOI: 10.29219/fnr.v68.10458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/09/2023] [Accepted: 12/20/2023] [Indexed: 04/05/2024] Open
Abstract
Background: Coffee, tea, sugar-sweetened beverages (SSBs), and low- and no-calorie sweetened beverages (LNCSBs) are generally frequently consumed in the Nordic and Baltic countries. These beverages have also been related to potential health effects. This scoping review describes the evidence for the role of coffee, tea, SSBs, and LNCSBs for health-related outcomes as a basis for setting and updating food-based dietary guidelines. We used evidence from several qualified systematic reviews (i.e. World Cancer Research Fund, US Dietary Guidelines Advisory Committee, European Food Safety Authority, and World Health Organization) and performed a search for additional systematic reviews. The evidence suggests that moderate coffee and tea consumption do not have long-term adverse health effects. The long-term favorable effects of coffee consumption are related to reduced risk of endometrial and liver cancer, type 2 diabetes, and cardiovascular deaths. However, results from randomized controlled trials (RCTs) suggest that coffee brews that are rich in diterpenes, such as boiled coffee, increase serum cholesterol concentrations. High caffeine intake in pregnancy is associated with higher risk of pregnancy loss, preterm birth, and low birth weight. High consumption of SSBs has been associated with increased risk of obesity, type 2 diabetes, hypertension, and cardiovascular disease, based on data from RCTs and prospective cohort studies. The consumption of LNCSBs may result in a small reduction in body weight in adults, likely mediated through the effect of reduced energy intake, but has neutral effects on other cardiometabolic risk markers using evidence from RCTs. However, evidence from observational studies indicates increased risk of cardiometabolic diseases among high LNCSB consumers. In conclusion, current evidence suggests that moderate coffee and tea consumption have no long-term adverse health effects. The evidence of beneficial effects of coffee consumption on liver and endometrial cancer risk, and some cardiovascular outcomes, comes from observational studies. High consumption of boiled coffee should be avoided due to negative effect on lipid profile. Pregnant women should not exceed the recommended daily dose of caffeine intake of 200 mg set by the European Food Safety Authority as a safe level for the fetus. High consumption of SSBs has consistently been associated with adverse health effects, which is mainly due to excess energy intake, and should be limited. The conflicting results from RCTs and observational studies regarding LNCSBs may be due to revere causation and should be explored further.
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Affiliation(s)
- Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Marko Lukic
- Department of Community Medicine, Faculty of Health Sciences, UiT – The Arctic University of Norway, Tromsø, Norway
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Lisowska A, Kasiak P, Rząca M. Assessment of caffeine intake in groups of pregnant and breastfeeding women: A cross-sectional analysis. Clin Nutr ESPEN 2023; 57:151-157. [PMID: 37739650 DOI: 10.1016/j.clnesp.2023.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Caffeine is commonly consumed by pregnant and breastfeeding women. The maximum safe dose of caffeine in their diet is 200 mg per day, according to the European Food Safety Authority. The purpose of this study was to assess the consumption of caffeinated products by pregnant and breastfeeding women, as well as to estimate their caffeine intake. METHODS The number of subjects who qualified for the study was 1112 women, of whom 401 were pregnant and 711 were breastfeeding. The research was conducted with the use of a questionnaire, which included information about food frequency and history of consumption of caffeinated products during the past 3 days. RESULTS The median (interquartile range) daily caffeine intake among pregnant women was 114.5 (57.6-202.8) mg, and the level of caffeine intake increased with the duration of pregnancy (p < 0.001). For breastfeeding women it was 193.7 (100.5-324.8) mg/d. The majority of participants (58.9%) were not able to correctly identify the safe amount of caffeine in their diets. It was observed that the intake of 73.8% of pregnant women and 51.9% of breastfeeding women fit within the safe range (0-200 mg/d). The main sources of caffeine were ground coffee, black tea, and instant coffee. For 63,6% of women knowledge about nutrition and supplementation came most often from blogs and social media run by medical professionals. Pleasure was the main reason for drinking coffee and tea. CONCLUSION Most pregnant women did not exceed the recommended maximum daily dose of caffeine, while breastfeeding women often did.
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Affiliation(s)
- Anna Lisowska
- The Faculty of Health Sciences of the Medical University of Warsaw, 02-091 Warsaw, Poland.
| | - Przemysław Kasiak
- 3rd Department of Internal and Medicine Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland.
| | - Marcin Rząca
- Department of Long-Term Care Nursing of the Medical University of Lublin, 20-093 Lublin, Poland.
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Atiba FA, Popoola OA, Odukogbe AA, Ihunwo AO. Prevalence and consumption pattern of kolanut among pregnant women in Ibadan metropolis. Sci Rep 2023; 13:14422. [PMID: 37660226 PMCID: PMC10475128 DOI: 10.1038/s41598-023-41754-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/31/2023] [Indexed: 09/04/2023] Open
Abstract
Kolanut contains caffeine and it is widely consumed in various social contexts in Nigeria and other Sub-Saharan African countries. While some studies have suggested that kolanut is consumed by pregnant women, there is a dearth of information on the prevalence, consumption pattern and reasons for kolanut consumption among this group. This study investigated kolanut use among pregnant women in Ibadan, Oyo State, Nigeria. A cross-sectional study involving 478 consenting pregnant women in all trimesters of pregnancy was conducted. Semi-structured questionnaires were used to collect data. Associations between kolanut use and respondent characteristics were investigated using the chi-square test and logistic regression analysis. The mean age of the women was 28.7 ± 6.3 years. One hundred and sixty-two (33.9%) of women reported kolanut use during pregnancy, 140 (29.3%) in the current pregnancy. Fifty-five (39.3%) pregnant women reported frequent use and 46 (32.9%) used it in high quantities. Significant associations were found between current kolanut use and Hausa respondents (p = 0.014), educational level; secondary (p = 0.032), tertiary (p = 0.006), TBA (p = 0.005). The majority (93.7%) used kolanut to prevent spitting, nausea, and vomiting. This study showed that kolanut use is quite common among pregnant women and frequently used in large quantities.
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Affiliation(s)
- F A Atiba
- Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Nigeria.
- School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - O A Popoola
- Departrment of Community Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - A A Odukogbe
- Department of Obstetrics and Gynecology College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - A O Ihunwo
- School of Anatomical Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Wootton RE, Lawn RB, Magnus MC, Treur JL, Corfield EC, Njølstad PR, Andreassen OA, Lawlor DA, Munafò MR, Håberg SE, Davey Smith G, Reichborn-Kjennerud T, Magnus P, Havdahl A. Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa). BMC Med 2023; 21:125. [PMID: 37013617 PMCID: PMC10071662 DOI: 10.1186/s12916-023-02831-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Guidance to improve fertility includes reducing alcohol and caffeine consumption, achieving healthy weight-range and stopping smoking. Advice is informed by observational evidence, which is often biased by confounding. METHODS This study primarily used data from a pregnancy cohort, the Norwegian Mother, Father and Child Cohort Study. First, we conducted multivariable regression of health behaviours (alcohol and caffeine consumption, body-mass index (BMI), and smoking) on fertility outcomes (e.g. time to conception) and reproductive outcomes (e.g. age at first birth) (n = 84,075 females, 68,002 males), adjusting for birth year, education and attention-deficit and hyperactive-impulsive (ADHD) traits. Second, we used individual-level Mendelian randomisation (MR) to explore possible causal effects of health behaviours on fertility/reproductive outcomes (n = 63,376 females, 45,460 males). Finally, we performed summary-level MR for available outcomes in UK Biobank (n = 91,462-1,232,091) and controlled for education and ADHD liability using multivariable MR. RESULTS In multivariable regression analyses, higher BMI associated with fertility (longer time to conception, increased odds of infertility treatment and miscarriage), and smoking was associated with longer time to conception. In individual-level MR analyses, there was strong evidence for effects of smoking initiation and higher BMI on younger age at first birth, of higher BMI on increased time to conception, and weak evidence for effects of smoking initiation on increased time to conception. Age at first birth associations were replicated in summary-level MR analysis; however, effects attenuated using multivariable MR. CONCLUSIONS Smoking behaviour and BMI showed the most consistent associations for increased time to conception and a younger age at first birth. Given that age at first birth and time to conception are positively correlated, this suggests that the mechanisms for reproductive outcomes are distinct to the mechanisms acting on fertility outcomes. Multivariable MR suggested that effects on age at first birth might be explained by underlying liability to ADHD and education.
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Affiliation(s)
- Robyn E Wootton
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Rebecca B Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jorien L Treur
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elizabeth C Corfield
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål R Njølstad
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
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An Overview of the Risks of Contemporary Energy Drink Consumption and Their Active Ingredients on Cardiovascular Events. CURRENT CARDIOVASCULAR RISK REPORTS 2023. [DOI: 10.1007/s12170-023-00716-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Sakali AK, Papagianni M, Bargiota A, Rasic-Markovic A, Macut D, Mastorakos G. Environmental factors affecting pregnancy outcomes. Endocrine 2023; 80:459-469. [PMID: 36729371 DOI: 10.1007/s12020-023-03307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Pregnancy represents a fragile period in the life of a woman, vulnerable to hazardous environmental substances which might affect maternal and fetal metabolism. The possible influence of environmental factors, including endocrine disrupting chemicals (EDCs), upon the mother and the fetus before and/or during pregnancy might be associated directly and/or indirectly to deleterious pregnancy outcomes. Because the existence of such associations would be, to our view, of major importance to the scientific community, their investigation is the scope of this critical review. METHODS This critical review includes in vivo animal and human studies regarding the role of environmental factors, including EDCs, on pregnancy outcomes complying with the SANRA (a scale for the quality assessment of narrative review articles) questions for narrative reviews. Studies were identified by searching the MEDLINE (PubMed and PubMed Central), the Cochrane library and the Google Scholar databases till October 2022 with the combinations of the appropriate key words (detailed environmental factors including EDCs AND detailed negative pregnancy outcomes) as well as by scanning references from already included articles and relevant reviews manually. Because environmental factors and EDCs have been associated to epigenetic alterations, special care has been given to EDC-induced transgenerational effects on pregnancy outcomes. RESULTS The existing evidence suggests positive associations between specific environmental factors and negative pregnancy outcomes such as ectopic pregnancies, pregnancy losses, gestational diabetes, hypertensive disorders of pregnancy, preterm births, birth defects, intrauterine growth restriction, and small or large for gestational age babies. CONCLUSION Environmental factors and EDCs may have a catalytic effect on the course and the outcomes of pregnancy.
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Affiliation(s)
- Anastasia-Konstantina Sakali
- Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Maria Papagianni
- Department of Nutrition and Dietetics, School of Physical Education and Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Endocrine Unit, 3rd Department of Pediatrics, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, University of Thessaly, Larissa, Greece
| | - Aleksandra Rasic-Markovic
- Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000, Belgrade, Serbia
| | - Djuro Macut
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Uechi K, Arakaki S, Sasaki S. Characteristics of women who dropped out from pregnancy register in Okinawa, Japan: Findings from a retrospective cohort study. J Obstet Gynaecol Res 2023; 49:164-174. [PMID: 36220630 DOI: 10.1111/jog.15461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 01/19/2023]
Abstract
AIM There is little evidence regarding women who cannot register live births after pregnancy. We aimed to clarify the difference in baseline characteristics between women who registered live births and those who did not (i.e., dropout). METHODS We assessed the birth cohort data of 1976 Japanese women who registered their pregnancies between July 2013 and March 2014 in Naha and Urasoe City, Okinawa, Japan. The database consisted of anthropometric data, reproductive history, sociodemographic characteristics, and dietary intake. We estimated the prevalence ratio to examine the associations of baseline characteristics with dropout by multivariable-adjusted Poisson regression with robust standard error estimation. RESULTS We identified 272 dropouts (13.8%) in the pregnancy registry. About 15% of women reported experience of alcohol drinking preceding 1 month of pregnancy registration. Most participants' vitamin B1 (92.1%) and folate (74.7%) consumption was inadequate considering the dietary reference intake for Japanese pregnant women, but it was not associated with a high prevalence of dropout. The prevalence of dropout was significantly higher in teenagers (prevalence ratio [PR] = 2.06, 95% confidence interval [CI] 1.38-3.07) and early 20s (PR = 1.42, 95% CI 1.04-1.93) than in women in late 20s. In addition, alcohol consumption was potentially associated with a high prevalence of dropout (adjusted prevalence ratio [aPR] = 1.31, 95% CI 0.99-1.73). Participants who experienced one or more live births (aPR = 0.43, 95% CI 0.28-0.66) were less likely to dropout. CONCLUSION We found that the potential risk factors for dropout from pregnancy registration were young maternal age, no childbirth experience, and alcohol consumption.
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Affiliation(s)
- Ken Uechi
- Division of Community Health Nursing, Faculty of Health Science, Toho University, Funabashi, Chiba, Japan
| | - Sugano Arakaki
- Okinawa Branch Office, Japan Health Insurance Association, Naha, Okinawa, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Román-Gálvez MR, Martín-Peláez S, Hernández-Martínez L, Cano-Ibáñez N, Olmedo-Requena R, Martínez-Galiano JM, Bueno-Cavanillas A, Amezcua-Prieto C. Caffeine Intake throughout Pregnancy, and Factors Associated with Non-Compliance with Recommendations: A Cohort Study. Nutrients 2022; 14:5384. [PMID: 36558543 PMCID: PMC9785327 DOI: 10.3390/nu14245384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Maternal caffeine consumption is associated with adverse gestational outcomes. The aim of this study was to assess the intake of caffeine and factors associated with the non-adherence to caffeine intake recommendations in a cohort of 463 women before (T0) and in each trimester of gestation (T1, T2, and T3), by using validated questionnaires. Caffeine intake (median (mg/day), IQR) was 100.0 (181.1) at T0, 9.42 (66.2) at T1, 12.5 (65.6) at T2, and 14.0 (61.1) at T3 (p < 0.001). Non-compliance prevalence (intake > 200 mg/day) was 6.2% at T1, 4.2% at T2, and 2.7% at T3. Not being an active smoker at T1 (OR = 0.17; 95% CI 0.05−0.59) and T2 (OR = 0.22; 95% CI 0.09−0.52), adherence to the Mediterranean Diet at T1 (OR = 0.50; 95% CI 0.28−0.88) and T2 (OR = 0.39; 95% CI 0.15−1.02), and moderate physical activity at T1 (OR = 0.50; 95% CI 0.28−0.88) were inversely associated with caffeine consumption. Although caffeine intake may be considered low, intake prevalence increases throughout pregnancy. Although the main source of caffeine during pregnancy is coffee, attention must be also paid to the increasingly intake of chocolate, of which the effect during pregnancy is controversial. Smoking, non-adherence to a good quality diet, and light physical activity are associated with a higher caffeine intake and a lower compliance with caffeine intake recommendations. Perinatal dietary and lifestyle educational policies are needed.
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Affiliation(s)
- María Rosario Román-Gálvez
- Unit of Clinical Management Alhama de Granada, Andalusian Health Service, 18120 Alhama de Granada, Spain
- Department of Nursing, University of Granada, 18006 Granada, Spain
| | - Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
| | | | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Juan Miguel Martínez-Galiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Nursing, University of Jaén, 23071 Jaén, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.Granada), 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
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Yuan S, Liu J, Larsson SC. Reply of the Authors: Smoking, alcohol, and coffee consumption and pregnancy loss: a Mendelian randomization investigation. Fertil Steril 2022; 118:1203-1204. [PMID: 36289043 DOI: 10.1016/j.fertnstert.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jin Liu
- Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Unit of Medical Epidemiology, Uppsala University, Uppsala, Sweden
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López García-Franco A, Baeyens Fernández JA, Iglesias Piñeiro MJ, Alonso Coello P, Ruiz Cabello C, Pereira Iglesias A, Landa Goñi J. [Preventive activities in women. PAPPS update 2022]. Aten Primaria 2022; 54 Suppl 1:102471. [PMID: 36435585 PMCID: PMC9705224 DOI: 10.1016/j.aprim.2022.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
In the 2022 PAPPS update we present those specific preventive activities for women's health, except those related to cancer prevention (which are included in another document) and those aspects related to differential gender morbidity, a cross-cutting aspect for all working groups. Contraception is an essential preventive activity, considering basic the right to decide both the number of children and the time to have them. We must inform about the possible contraceptive methods, guaranteeing the monitoring of their safety, efficacy and effectiveness (tables are included on changing from one method to another to preserve contraceptive protection). We must inform about emergency contraception and propose it in the event of unprotected intercourse. All this will be done through opportunistic screening without requiring screening for thrombophilia or dyslipidemia, but for arterial hypertension. Pregnancy is an important life experience and the family doctor should not remain oblivious. We must be competent both in the preconception consultation (recommending the intake of folic acid, avoiding exposure to occupational and environmental risks, screening for certain pathologies and assessing the intake of drugs not indicated during pregnancy) and in the monitoring of pregnancy. Whether or not we monitor the pregnancy, we must not disregard its control, taking advantage of this period to promote healthy lifestyles and participating in the intercurrent processes that may occur. Menopause in general and osteoporosis in particular exemplify the strategy of medicalization of vital processes that has been followed from different instances and organizations. In our update we address the prevention and treatment of symptoms secondary to estrogen deprivation. We also propose the prevention of osteoporosis, including carrying out densitometry based on the risk of fracture in the next 10 years, and therefore densitometric screening is not recommended in women under 60 years of age. In risk assessment we recommend the use of the frax tool or better, the calibration of the risk of hip fracture with prevalence data from our setting. We linked the indication for treatment with the Z-Score (bone mineral density compared with women of the same age), as it is a condition associated with aging.
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Affiliation(s)
- Alberto López García-Franco
- Medicina Familiar y Comunitaria, Centro de Salud Dr. Mendiguchía Carriche, Leganés, Madrid, España,Autor para correspondencia.
| | | | | | - Pablo Alonso Coello
- Medicina Familiar y Comunitaria, Centro Cochrane Iberoamericano (CIBERESP-IIB Sant Pau), Barcelona, España
| | - Cristina Ruiz Cabello
- Medicina Familiar y Comunitaria, Consultorio Castilléjar, zona básica de Benamaurel, Granada, España
| | - Ana Pereira Iglesias
- Medicina Familiar y Comunitaria, Centro de Salud Dr. Mendiguchía Carriche, Leganés, Madrid, España
| | - Jacinta Landa Goñi
- Medicina Familiar y Comunitaria, Centro de Salud Emisora, Pozuelo de Alarcón, Madrid, España
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Bombana M, Wensing M, Wittenborn L, Ullrich C. Health Education about Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Qualitative Study of Healthcare Providers' Views in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11674. [PMID: 36141943 PMCID: PMC9517227 DOI: 10.3390/ijerph191811674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Lifestyle-related risk factors (LRRFs) during pregnancy and lactation are associated with a range of health problems. However, previous studies have shown a large knowledge gap among pregnant women regarding the effects of LRRFs. This study aimed to investigate the role of health education about LRRFs during pregnancy and lactation in gynecological and obstetric care from healthcare providers' (HCPs) point of view. METHODS To explore the views of healthcare providers, a qualitative study was performed. In 2019, 22 in-depth interviews were conducted with a purposive sample of 9 gynecologists and 13 midwives. Participants came from different inpatient and outpatient care settings and from rural, urban, and socially deprived areas in southern Germany. All the interviews were tape-recorded and transcribed verbatim. A combined inductive and deductive approach was applied for data analysis. RESULTS Interviews with HCPs showed that they were aware of the possible impacts of LRRFs during pregnancy and lactation. They noted the importance of action, specifically among women with low socioeconomic status (SES), migrants, and women with a concerning medical history or other specific needs. However, the interviews showed that, at present, there is no standardized practice of educating patients on LRRFs in routine care. This was attributed to a lack of guidelines and time, unfavorable regulations, and undefined responsibilities. The priority of health education is lower in inpatient healthcare settings as compared to outpatient healthcare settings. HCPs apply a demand-driven healthcare approach, focusing on a woman's medical history, needs, and personal circumstances. HCPs voiced the importance of implementing pre-conception education across different healthcare settings, garnering support from other health organizations, and setting out clearly defined responsibilities among HCPs. CONCLUSIONS This qualitative study explored HCPs' perspectives on health education about LRRFs during pregnancy and lactation. The results from this study emphasize the need for a central strategy for health education about LRRFs during pregnancy and lactation in gynecological and obstetric care.
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Affiliation(s)
- Manuela Bombana
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Prevention, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany
| | - Michel Wensing
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Lisa Wittenborn
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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15
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Jafari A, Naghshi S, Shahinfar H, Salehi SO, Kiany F, Askari M, Surkan PJ, Azadbakht L. Relationship between maternal caffeine and coffee intake and pregnancy loss: A grading of recommendations assessment, development, and evaluation-assessed, dose-response meta-analysis of observational studies. Front Nutr 2022; 9:886224. [PMID: 36017225 PMCID: PMC9396037 DOI: 10.3389/fnut.2022.886224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Numerous studies report an association between coffee or caffeine consumption and pregnancy loss; however, the nature and strength of this relationship have not been clearly established. Based on recent studies, our meta-analysis aimed to test whether a dose-response relationship between coffee or caffeine consumption and pregnancy loss exists. Methods We searched for articles in PubMed, Web of Science, and Scopus published until May 2022. Two independent reviewers extracted data and rated the quality of the evidence using the GRADE approach. We applied a random-effects, one-stage dose-response meta-analysis. Results A total of 34 articles (18 cohort studies and 16 case-control studies) were included in this review. Results showed a significantly higher risk of pregnancy loss for coffee consumption before (Pooled ES: 1.21; 95% CI: 1.01-1.43) and during pregnancy (Pooled ES: 1.26; 95% CI: 1.04-1.57), and for coffee consumption during pregnancy in case-control studies (Pooled ES: 1.20; 95% CI: 1.19-6.41). Findings from this meta-analysis demonstrated that caffeine intake during pregnancy was associated with a significantly higher risk of pregnancy loss in cohort (Pooled ES: 1.58; 95% CI: 1.23-2.01) and case-control studies (Pooled ES: 2.39; 95% CI: 1.69-3.37, P < 0.001), respectively. A dose-response analysis suggested that an increase of a cup of coffee per day during pregnancy was associated with 3% increased risk of pregnancy loss; 100 mg of caffeine per day during pregnancy was also associated with 14 and 26% increased risk of pregnancy loss in cohort and case-control studies, respectively. A non-linear dose-response association was observed between coffee intake and the risk of pregnancy loss. Conclusion This study confirms that coffee or caffeine consumption raises the risk of pregnancy loss. Researchers are encouraged to conduct more studies to explore the underlying mechanisms and active compounds in coffee and caffeine. Systematic Review Registration [www.crd.york.ac.uk/prospero/], identifier [CRD42021267731].
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Affiliation(s)
- Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, Iran University of Medical Sciences, Tehran, Iran.,Student Research Committee, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sayed Omid Salehi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Kiany
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Science, Isfahan, Iran
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16
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Lee Y, Choi S, Jung H. Self-Care Mobile Application for South Korean Pregnant Women at Work: Development and Usability Study. Risk Manag Healthc Policy 2022; 15:997-1009. [PMID: 35585874 PMCID: PMC9109729 DOI: 10.2147/rmhp.s360407] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background Pregnant women at work often encounter barriers to participating in prenatal education or conducting appropriate self-care practices due to their working conditions. Purpose We aimed at developing a mobile-based intervention application (SPWW) for Korean pregnant women at work and testing its usability and preliminary effects to enhance their self-care practices. Patients and Methods The application was developed and tested with thirty-one pregnant women at work and thirteen women's healthcare providers. The instruments used in this study were a modified Health Practices in Pregnancy Questionnaire II and a System Usability Scale. Descriptive analyses and t-tests were performed using SPSS 25.0. The participants' open-ended answers were analyzed using ATLAS. ti 8. Results We developed the application focusing on four self-care topics: healthy diet, physical activity, sufficient rest, and stress management. After using the application for two weeks, participants' levels of exercise (p = 0.006), adequate fluid intake (p = 0.002), and limiting daily caffeine intake (p = 0.048) significantly improved. In addition to good usability scores, the suggestions for improvement made by the participants included diversifying the educational materials and adding individually customizable functions to the application. Conclusion The application developed in this study enhanced self-care practices of pregnant women at work and showed adequate levels of usability. We expect the developmental process and details of the application provided in this study to serve as a sample guide for future studies.
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Affiliation(s)
- Yaelim Lee
- College of Nursing, Catholic University of Korea, Seoul, Republic of Korea
- Redcross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Soeun Choi
- Department of Nursing, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea
| | - Heejae Jung
- Department of Nursing, Seoul National University Hospital, Seoul, Republic of Korea
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Corrales-Gutierrez I, Baena-Antequera F, Gomez-Baya D, Leon-Larios F, Mendoza R. Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities. Nutrients 2022; 14:nu14030557. [PMID: 35276912 PMCID: PMC8839613 DOI: 10.3390/nu14030557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child's. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies.
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Affiliation(s)
- Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, University of Seville, 41009 Seville, Spain
| | - Francisca Baena-Antequera
- Obstetric Unit, University Hospital Virgen de Valme, 41014 Seville, Spain
- Nursing Department, Osuna’s University School, 41640 Osuna, Spain
- Correspondence: ; Tel.: +34-615-51-95-65
| | - Diego Gomez-Baya
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Ramon Mendoza
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
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18
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Pascoe M, Foldvary-Schaefer N. Pregnancy and Contraception in Central Hypersomnolence Disorders. CURRENT SLEEP MEDICINE REPORTS 2021. [DOI: 10.1007/s40675-021-00221-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Lv F, Fan G, Wan Y, Chen Y, Ni Y, Huang J, Xu D, Zhang W, Wang H. Intrauterine endogenous high glucocorticoids program ovarian dysfunction in female offspring secondary to prenatal caffeine exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 789:147691. [PMID: 34082199 DOI: 10.1016/j.scitotenv.2021.147691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/27/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
Ovarian dysfunction has an intrauterine origin, and prenatal caffeine exposure (PCE) could lead to abnormal follicle counts in offspring after birth. However, the effect of PCE on offspring ovarian function and its mechanism of intrauterine programming have not been reported thus far. In this study, pregnant Wistar rats were intragastrically administered caffeine (30 and 120 mg/kg·d) at gestational days 9-20 (GD9-20). Certain tests were performed on the blood, ovaries and hypothalamus of female offspring at different time points. PCE female offspring had ovarian dysfunction in adulthood compared with the control. Further results showed that in utero ovarian morphological development and estradiol synthesis were inhibited but rapidly increased during puberty in the PCE group. The histone 3 lysine 27 acetylation (H3K27ac) level of the insulin-like growth factor 1 (IGF1) promoter region and its expression were decreased in the ovary, which was due to exposure to high levels of fetal blood corticosterone, and the H3K27ac level of IGF1 and its expression shifted to increase after birth with a decrease in serum corticosterone levels. Chronic stress led to increased serum corticosterone levels in adult offspring, whereas ovarian morphological development, the H3K27ac level of IGF1 and its expression, and estradiol synthesis were significantly inhibited. Moreover, the activity of the hypothalamic-pituitary-ovarian (HPO) axis was increased in the early postnatal period of PCE offspring, and chronic stress reversed these changes. In the KGN cell line, it was found that cortisol could promote the translocation of the glucocorticoid receptor (GR) into the nucleus and upregulate histone deacetylase 10 (HDAC10) to inhibit the H3K27ac level of IGF1 and its expression and estradiol synthesis. In summary, PCE is associated with ovarian dysfunction in female adult offspring, and the potential mechanism is related to intrauterine high glucocorticoid exposure by activating the GR and recruiting HDAC10 to affect ovarian glucocorticoid-IGF1 axis programming and to inhibit estradiol synthesis.
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Affiliation(s)
- Feng Lv
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Guanlan Fan
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yang Wan
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Yunxi Chen
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Yuan Ni
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Jing Huang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Dan Xu
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Wei Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan 430071, China; Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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20
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Li S, Song JM, Zhang K, Zhang CL. A Meta-Analysis of Erectile Dysfunction and Alcohol Consumption. Urol Int 2021; 105:969-985. [PMID: 34521090 DOI: 10.1159/000508171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/16/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of the study was to evaluate the association between alcohol consumption and risk of erectile dysfunction (ED). METHODS PubMed was searched for reports published before June 2019. Data were extracted and combined odds ratios (ORs) calculated with random-effects models. RESULTS Finally, 46 studies were included (216,461 participants). The results of our meta-analysis indicated that there was a significant association between regular alcohol consumption and ED (OR 0.89, 95% confidence interval [CI]: 0.81-0.97). There was no indication of publication bias (Egger's test, p = 0.37). In the stratified analysis, the pooled OR of ED for light to moderate and high alcohol consumption was 0.82 (95% CI: 0.72-0.94) and 0.82 (95% CI: 0.67-1.00), respectively. No variable related to the source of heterogeneity was found in univariate and multivariate meta-regression analyses. A dose-response meta-analysis suggested that a nonlinear relationship between alcohol consumption and risk of ED was observed (p for nonlinearity <0.001). CONCLUSION A J-shaped relationship between alcohol consumption and risk of ED was observed. Alcohol should be taken in moderate quantities in order to obtain the dual effect of disinhibition and relaxation. If taken chronically, it could provoke vascular damages.
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Affiliation(s)
- Shen Li
- Department of Medical Administration, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ju-Min Song
- Department of Medical Administration, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ke Zhang
- Office of Party Committee, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chang-Le Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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21
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Caffeine use during pregnancy: prevalence of use and newborn consequences in a cohort of French pregnant women. Eur Arch Psychiatry Clin Neurosci 2021; 271:941-950. [PMID: 32086556 DOI: 10.1007/s00406-020-01105-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
Abstract
Many pregnant women, in the world, drink caffeine-containing beverages. Maternal caffeine consumption during pregnancy may have adverse effects on foetus but results are conflicting. Our goals were to estimate the prevalence of caffeine use in a cohort of French pregnant women using maternal self-reports and to evaluate the association between caffeine consumption during pregnancy and delivery and newborn characteristics. All pregnant women who gave birth in a large French urban area during a limited period of time were included (in total 724 mothers were included). Coffee, tea or cola consumption as well as pregnancy and neonate characteristics were analysed. The mean consumption of caffeine per day slightly decreased from the first to the third trimester of pregnancy: 587 caffeine users, with a consumption of caffeine of 59.2 ± 61.5 mg/day during the first trimester as compared to 577 consumers (54.3 ± 55.4 mg/day) during the third trimester, respectively. A significant decrease of neonates' birth length was observed when mothers were using at least 100 mg/day (or two cups) of caffeine during the second and third trimesters but this difference was no longer significant after adjustment on potential confounding factors such as tobacco use. The potential existence of other confounders (e.g. poorer dietary habits or other lifestyle variables) that might also be associated with reduced birth length, may not be excluded. Caffeine use during pregnancy was associated with reduced birth length but this effect was no longer significant after adjustment on potential confounding variables.
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22
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Risk score to stratify miscarriage risk levels in preconception women. Sci Rep 2021; 11:12111. [PMID: 34103654 PMCID: PMC8187346 DOI: 10.1038/s41598-021-91567-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/28/2021] [Indexed: 12/03/2022] Open
Abstract
Spontaneous miscarriage is one of the most common complications of pregnancy. Even though some risk factors are well documented, there is a paucity of risk scoring tools during preconception. In the S-PRESTO cohort study, Asian women attempting to conceive, aged 18-45 years, were recruited. Multivariable logistic regression model coefficients were used to determine risk estimates for age, ethnicity, history of pregnancy loss, body mass index, smoking status, alcohol intake and dietary supplement intake; from these we derived a risk score ranging from 0 to 17. Miscarriage before 16 weeks of gestation, determined clinically or via ultrasound. Among 465 included women, 59 had miscarriages and 406 had pregnancy ≥ 16 weeks of gestation. Higher rates of miscarriage were observed at higher risk scores (5.3% at score ≤ 3, 17.0% at score 4–6, 40.0% at score 7–8 and 46.2% at score ≥ 9). Women with scores ≤ 3 were defined as low-risk level (< 10% miscarriage); scores 4–6 as intermediate-risk level (10% to < 40% miscarriage); scores ≥ 7 as high-risk level (≥ 40% miscarriage). The risk score yielded an area under the receiver-operating-characteristic curve of 0.74 (95% confidence interval 0.67, 0.81; p < 0.001). This novel scoring tool allows women to self-evaluate their miscarriage risk level, which facilitates lifestyle changes to optimize modifiable risk factors in the preconception period and reduces risk of spontaneous miscarriage.
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James JE. Maternal caffeine consumption and pregnancy outcomes: a narrative review with implications for advice to mothers and mothers-to-be. BMJ Evid Based Med 2021; 26:114-115. [PMID: 32843532 PMCID: PMC8165152 DOI: 10.1136/bmjebm-2020-111432] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Caffeine is a habit-forming substance consumed daily by the majority of pregnant women. Accordingly, it is important that women receive sound evidence-based advice about potential caffeine-related harm. This narrative review examines evidence of association between maternal caffeine consumption and negative pregnancy outcomes, and assesses whether current health advice concerning maternal caffeine consumption is soundly based. METHODS Database searches using terms linking caffeine and caffeinated beverages to pregnancy outcomes identified 1261 English language peer-reviewed articles. Screening yielded a total of 48 original observational studies and meta-analyses of maternal caffeine consumption published in the past two decades. The articles reported results for one or more of six major categories of negative pregnancy outcomes: miscarriage, stillbirth, low birth weight and/or small for gestational age, preterm birth, childhood acute leukaemia, and childhood overweight and obesity. RESULTS Of 42 separate sets of findings reported in 37 observational studies, 32 indicated significantly increased caffeine-related risk and 10 suggested no or inconclusive associations. Caffeine-related increased risk was reported with moderate to high levels of consistency for all pregnancy outcomes except preterm birth. Of 11 studies reporting 17 meta-analyses, there was unanimity among 14 analyses in finding maternal caffeine consumption to be associated with increased risk for the four outcome categories of miscarriage, stillbirth, low birth weight and/or small for gestational age, and childhood acute leukaemia. The three remaining meta-analyses were also unanimous in reporting absence of a reliable association between maternal caffeine consumption and preterm birth. No meta-analyses were identified for childhood overweight and obesity, although four of five original observational studies reported significant associations linking maternal caffeine consumption to that outcome category. CONCLUSIONS The substantial majority finding from observational studies and meta-analyses is that maternal caffeine consumption is reliably associated with major negative pregnancy outcomes. Reported findings were robust to threats from potential confounding and misclassification. Among both observational studies and meta-analyses, there were frequent reports of significant dose-response associations suggestive of causation, and frequent reports of no threshold of consumption below which associations were absent. Consequently, current evidence does not support health advice that assumes 'moderate' caffeine consumption during pregnancy is safe. On the contrary, the cumulative scientific evidence supports pregnant women and women contemplating pregnancy being advised to avoid caffeine.
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Affiliation(s)
- Jack E James
- Psychology, Reykjavik University, 101 Reykjavik, Iceland
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Olechno E, Puścion-Jakubik A, Zujko ME, Socha K. Influence of Various Factors on Caffeine Content in Coffee Brews. Foods 2021; 10:1208. [PMID: 34071879 PMCID: PMC8228209 DOI: 10.3390/foods10061208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/25/2022] Open
Abstract
Coffee brews are one of the most popular drinks. They are consumed for caffeine and its stimulant properties. The study aimed to summarize data on the influence of various factors on caffeine content in brews prepared with different methods. The study was carried out using a literature review from 2010-2020. PubMed and Google Scholar databases were searched. Data on caffeine content was collected by analyzing the following factors: the influence of species, brewing time, water temperature, pressure, degree of roast, grinding degree, water type, water/coffee ratio as well as other factors (such as geographical origin). To sum up, converting caffeine content to 1 L of the brew, the highest content is that of brews prepared in an espresso machine (portafilter), with the amount of 7.5 g of a coffee blend (95% Robusta + 5% Arabica), and water (the volume of coffee brew was 25 mL) at a temperature of 92 °C and a pressure of 7 bar, but the highest content in one portion was detected in a brew of 50 g of Robusta coffee poured with 500 mL of cold water (25 °C) and boiled.
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Affiliation(s)
- Ewa Olechno
- Department of Food Biotechnology, Faculty of Health Science, Medical University of Białystok, Szpitalna 37 Street, 15-295 Białystok, Poland; (E.O.); (M.E.Z.)
| | - Anna Puścion-Jakubik
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland;
| | - Małgorzata Elżbieta Zujko
- Department of Food Biotechnology, Faculty of Health Science, Medical University of Białystok, Szpitalna 37 Street, 15-295 Białystok, Poland; (E.O.); (M.E.Z.)
| | - Katarzyna Socha
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland;
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Pereira-Figueiredo D, Nascimento AA, Cunha-Rodrigues MC, Brito R, Calaza KC. Caffeine and Its Neuroprotective Role in Ischemic Events: A Mechanism Dependent on Adenosine Receptors. Cell Mol Neurobiol 2021; 42:1693-1725. [PMID: 33730305 DOI: 10.1007/s10571-021-01077-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Ischemia is characterized by a transient, insufficient, or permanent interruption of blood flow to a tissue, which leads to an inadequate glucose and oxygen supply. The nervous tissue is highly active, and it closely depends on glucose and oxygen to satisfy its metabolic demand. Therefore, ischemic conditions promote cell death and lead to a secondary wave of cell damage that progressively spreads to the neighborhood areas, called penumbra. Brain ischemia is one of the main causes of deaths and summed with retinal ischemia comprises one of the principal reasons of disability. Although several studies have been performed to investigate the mechanisms of damage to find protective/preventive interventions, an effective treatment does not exist yet. Adenosine is a well-described neuromodulator in the central nervous system (CNS), and acts through four subtypes of G-protein-coupled receptors. Adenosine receptors, especially A1 and A2A receptors, are the main targets of caffeine in daily consumption doses. Accordingly, caffeine has been greatly studied in the context of CNS pathologies. In fact, adenosine system, as well as caffeine, is involved in neuroprotection effects in different pathological situations. Therefore, the present review focuses on the role of adenosine/caffeine in CNS, brain and retina, ischemic events.
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Affiliation(s)
- D Pereira-Figueiredo
- Neurobiology of the Retina Laboratory, Biomedical Sciences Program, Biomedical Institute, Fluminense Federal University, Niterói, RJ, Brazil
| | - A A Nascimento
- Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - M C Cunha-Rodrigues
- Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - R Brito
- Laboratory of Neuronal Physiology and Pathology, Cellular and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - K C Calaza
- Neurobiology of the Retina Laboratory, Biomedical Sciences Program, Biomedical Institute, Fluminense Federal University, Niterói, RJ, Brazil. .,Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil. .,Neurobiology Department, Biology Institute of Fluminense Federal University, Niteroi, RJ, Brazil.
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Kawanishi Y, Kakigano A, Kimura T, Ikehara S, Sato T, Tomimatsu T, Kimura T, Iso H. Hypertensive Disorders of Pregnancy in Relation to Coffee and Tea Consumption: The Japan Environment and Children's Study. Nutrients 2021; 13:nu13020343. [PMID: 33498916 PMCID: PMC7912571 DOI: 10.3390/nu13020343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 01/23/2023] Open
Abstract
Background: The association between coffee/tea intake and hypertensive disorders of pregnancy (HDP) remains unclear. This study aimed to investigate the association of caffeine, coffee, and tea intake during pregnancy with the risk of HDP. Methods: We assessed this association in 85,533 singleton pregnant women with live births in the Japan Environment and Children’s Study, a prospective cohort in Japan that included women from early pregnancy onward. Caffeinated and decaffeinated coffee and tea (green, oolong, and black) consumption during pregnancy was assessed using a validated food frequency questionnaire conducted at mid-pregnancy, and caffeine intake was calculated based on coffee and tea consumption. Multivariable logistic regression was used to assess the association with the risk of HDP. Results: HDP developed in 2222 women (2.6%). Caffeine intake was weakly associated with increased risk of HDP; the multivariable odds ratio of HDP for the highest versus the lowest quartile was 1.26 (95% confidence interval: 1.11, 1.43). Coffee drinkers of two or more cups per day showed a decreased risk compared with non-drinkers (multivariable odds ratio 0.79; 0.62, 0.99) even after adjustment for total caffeine intake. Tea consumption was not associated with the risk of HDP. Conclusions: Our study suggests that higher caffeine intake may increase HDP risk, while coffee drinkers had a lower risk. Further high-quality studies are needed to replicate these findings, and to elucidate if other substances in coffee may be protective against HDP.
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Affiliation(s)
- Yoko Kawanishi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; (Y.K.); (T.T.); (T.K.)
| | - Aiko Kakigano
- Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular Center, 6-1, Kisibeshinmachi, Suita-shi, Osaka 564-8565, Japan;
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo-Shi, Hokkaido 060-8638, Japan;
| | - Satoyo Ikehara
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan;
| | - Takuyo Sato
- Division of Community Health and Research, Osaka Women’s and Children’s Hospital, 840, Murodocho, Izumi-shi, Osaka 594-1101, Japan;
| | - Takuji Tomimatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; (Y.K.); (T.T.); (T.K.)
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan; (Y.K.); (T.T.); (T.K.)
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan;
- Correspondence: ; Tel.: +81-6-6879-3911
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Abstract
Numerous studies have examined the association between maternal caffeine consumption and infant and childhood health outcomes and the results have been inconsistent. The study of maternal caffeine intake and infant and childhood health outcomes is prone to methodologic challenges. In this review, we examine the existing evidence juxtaposed with the epidemiologic design challenges that color the interpretation of the study results presented. In light of methodologic/interpretation challenges, it seems reasonable to infer that exposure to low levels of caffeine is probably not associated with substantial infant and childhood adversities. However, more research is needed using well designed studies that address methodologic challenges.
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Affiliation(s)
| | - Alan Leviton
- Boston Children's Hospital & Harvard Medical School, Brookline, MA, USA
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Oechsle A, Wensing M, Ullrich C, Bombana M. Health Knowledge of Lifestyle-Related Risks during Pregnancy: A Cross-Sectional Study of Pregnant Women in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228626. [PMID: 33233790 PMCID: PMC7699927 DOI: 10.3390/ijerph17228626] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate (1) pregnant women’s level of knowledge of lifestyle-related risk factors during pregnancy and their potential health impact on their offspring, and (2) the factors affecting women’s knowledge of lifestyle-related risk factors during pregnancy. A cross-sectional observational study of pregnant women was carried out in obstetric and gynecologic care settings at three hospitals in Southern Germany. Data from 209 pregnant women revealed large knowledge gaps on lifestyle-related risk factors during pregnancy and their potential health impact. Factors affecting women’s knowledge of lifestyle-related risk factors during pregnancy were specifically associated with socioeconomic status, e.g., lower household net income, middle educational level, and statutory health insurance status. Women who had received information from their gynecologist had a higher level of knowledge of lifestyle-related risk factors during pregnancy. This study showed that health promotion regarding lifestyle-related risks during pregnancy specifically needs to address women from the low-to-middle socioeconomic status group. Gynecologists seem particularly effective in providing this information.
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Affiliation(s)
- Anja Oechsle
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (A.O.); (M.W.); (C.U.)
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (A.O.); (M.W.); (C.U.)
| | - Charlotte Ullrich
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (A.O.); (M.W.); (C.U.)
| | - Manuela Bombana
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (A.O.); (M.W.); (C.U.)
- Department of Health Promotion, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany
- Correspondence: ; Tel.: +49-711-2593-7945
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Mannucci C, Attard E, Calapai F, Facchinetti F, D'Anna R, Vannacci A, Santamaria A, Lenti MC, Righi M, Perone M, Sorbara EE, Alibrandi A, Oteri A, Inferrera G, Calapai G. Coffee intake during pregnancy and neonatal low birth weight: data from a multicenter Italian cross sectional study. J Matern Fetal Neonatal Med 2020; 35:4365-4369. [PMID: 33207986 DOI: 10.1080/14767058.2020.1849120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Aim: Coffee intake is common during pregnancy. However, the influence of coffee and caffeine on pregnancy has not yet been fully determined. Some studies show that high coffee intake could cause miscarriage, preterm birth or reduction of fetal growth, but other studies do not support these findings. The aim of the present study was to analyze data collected from a database focusing on coffee intake during pregnancy, which was specifically created for multicenter studies carried out in the maternity units of Italian general hospitals. Principal outcomes of pregnancy during pregnancy were considered. Methods: Data of 5405 pregnancies were collected by a direct questionnaire supplemented with data from patients'clinical records during the survey named PHYTO.VIG.GEST. Results: We observed that 42.3% of the total sample had consumed at least one coffee a day during pregnancy. Analysis of a dose-response relationship showed that, in pregnant women starting from the consumption of three coffees a day (6% of pregnant women consuming coffee), there is a statistically significant association between number of coffees and reduction of babies birth weight (< 2500 g). Coclusion: Even though high coffee intake is known to influence negatively birth weight, our results indicate that a significant percentage of pregnant women maintain this habit.
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Affiliation(s)
- Carmen Mannucci
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Everaldo Attard
- Institute of Earth Systems, Division of Rural Sciences and Food Systems, University of Malta, Msida, Malta
| | - Fabrizio Calapai
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Fabio Facchinetti
- Department of Mother-Infant, University of Modena and Reggio Emilia, Modena, Italy
| | - Rosario D'Anna
- Department of Mother-Infant, University of Messina, Messina, Italy
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, University of Florence, Italy
| | | | - Maria Carmela Lenti
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, Tuscan Regional Centre of Pharmacovigilance and Phytovigilance, University of Florence, Italy
| | - Maria Righi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Marcello Perone
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Emanuela E Sorbara
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | | | - Giuseppina Inferrera
- Hospital Pharmacy Service, Policlinico "G. Martino" Messina - University of Messina, Italy
| | - Gioacchino Calapai
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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López García-Franco A, Baeyens Fernández JA, Bailón Muñoz E, Iglesias Piñeiro MJ, Ortega Del Moral A, Coello PA, Ruiz Cabello C, Landa Goñi J, Arribas Mir L. [Preventive activities in women's care]. Aten Primaria 2020; 52 Suppl 2:125-148. [PMID: 33388112 PMCID: PMC7801221 DOI: 10.1016/j.aprim.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022] Open
Abstract
A review is presented of the scientific evidence on preventive activities in women's care in relation to pregnancy follow-up, preventive activities in the planning and follow-up of contraceptive methods, preventive activities in menopause, and the prevention of osteoporotic fractures.
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Affiliation(s)
| | | | - Emilia Bailón Muñoz
- Medicina Familiar y Comunitaria, Centro de Salud Universitario de Albaycín, Granada, España
| | | | | | - Pablo Alonso Coello
- Medicina Familiar y Comunitaria, Centro Cochrane Iberoamericano (CIBERESP-IIB Sant Pau), Barcelona, España
| | - Cristina Ruiz Cabello
- Medicina Familiar y Comunitaria, Consultorio Castilléjar, zona básica de Benamaurel, Granada, España
| | - Jacinta Landa Goñi
- Medicina Familiar y Comunitaria, Centro de Salud Emisora, Pozuelo de Alarcón, Madrid, España
| | - Lorenzo Arribas Mir
- Medicina Familiar y Comunitaria, Centro de Salud Universitario La Chana, Granada, España
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Nkrumah I, North M, Kothe E, Chai TL, Pirotta S, Lim S, Hill B. The Relationship Between Pregnancy Intentions and Diet or Physical Activity Behaviors in the Preconception and Antenatal Periods: A Systematic Review and Meta-Analysis. J Midwifery Womens Health 2020; 65:660-680. [PMID: 32592533 DOI: 10.1111/jmwh.13112] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Healthy preconception and antenatal diet and physical activity behaviors may optimize maternal and offspring outcomes. These behaviors are thought to be linked to pregnancy intentions. The aim of this study was to conduct a systematic review and meta-analysis to determine the association between women's pregnancy intentions and diet or physical activity behaviors in the preconception and antenatal periods. METHODS MEDLINE Complete, PsycINFO, CINAHL Complete, Global Health, Embase, and INFORMIT: Health Subset were searched in September 2018 for studies that evaluated relationships between pregnancy intentions and dietary and physical activity behaviors. Risk of bias was assessed, and random effects meta-analyses were conducted for dietary (food groups; energy and macronutrients; diet quality; and caffeine, iodine, and folate intake) and physical activity outcomes. RESULTS Of 2623 screened records, 19 eligible studies were identified. The overall risk of bias was moderate to high. Twelve studies measured diet and physical activity behaviors during preconception, 5 during pregnancy, and 2 across both periods. Eleven studies measured pregnancy intention retrospectively, and 8 prospectively measured pregnancy intention. The number of studies available for meta-analyses of individual dietary and physical activity outcomes ranged from 2 to 5. Pregnancy intentions were not associated with preconception fruit, vegetable, or caffeine intake or physical activity. Antenatally, women with intended pregnancies were more likely to report healthier diets, lower caffeine intake, and higher physical activity. Insufficient studies were available to conduct subgroup comparisons for prospective or retrospective assessment. DISCUSSION Pregnancy intentions were not associated with preconception diet or physical activity behaviors. In contrast, antenatally, women with intended pregnancies demonstrated better diet and physical activity behaviors. Given the small number of studies available for meta-analyses, further research is needed to consolidate our findings. Meanwhile, health professionals can assess women's pregnancy intentions during preconception and pregnancy and encourage a healthy lifestyle.
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Affiliation(s)
- Isaac Nkrumah
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Garden City University College, Kumasi, Ghana
| | - Madelon North
- School of Psychology, Deakin University, Geelong, Australia
| | - Emily Kothe
- School of Psychology, Deakin University, Geelong, Australia
| | - Tze Lin Chai
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Stephanie Pirotta
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Min H, Youn E, Shim YH. Maternal Caffeine Intake Disrupts Eggshell Integrity and Retards Larval Development by Reducing Yolk Production in a Caenorhabditis elegans Model. Nutrients 2020; 12:nu12051334. [PMID: 32392893 PMCID: PMC7284833 DOI: 10.3390/nu12051334] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022] Open
Abstract
During pregnancy, most women are exposed to caffeine, which is a widely consumed psychoactive substance. However, the consequences of maternal caffeine intake on the child remain largely unknown. Here, we investigated the intergenerational effects of maternal caffeine intake on offspring in a Caenorhabditis elegans model. We treated a young mother (P0) with 10 mM of caffeine equivalent to 2–5 cans of commercial energy drinks and examined its reproduction and growth rate from P0 to F2 generation. The fertility decreased and embryonic lethality increased by defective oocytes and eggshell integrity in caffeine-ingested mothers, and F1 larval development severely retarded. These results were due to decreased production of vitellogenin protein (yolk) in caffeine-ingested mothers. Furthermore, effects of RNA interference of vitellogenin (vit) genes, vit-1 to vit-6, in P0 mothers can mimic those by caffeine-ingested mothers. In addition, RNA interference (RNAi) depletion of unc-62 (human Meis homeobox), a transcriptional activator for vit genes, also showed similar effects induced by caffeine intake. Taken together, maternal caffeine intake reduced yolk production mediated by the UNC-62 transcription factor, thereby disrupting oocyte and eggshell integrity and retarding larval development. Our study suggests the clinical significance of caffeine intake for prospective mothers.
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Affiliation(s)
| | | | - Yhong-Hee Shim
- Correspondence: ; Tel.: +82-2-450-4059; Fax: +82-2-455-9956
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Caffeine content in newborn hair correlates with maternal dietary intake. Eur J Nutr 2020; 60:193-201. [PMID: 32246261 PMCID: PMC7867507 DOI: 10.1007/s00394-020-02231-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/18/2020] [Indexed: 10/26/2022]
Abstract
PURPOSE High-maternal caffeine intake during pregnancy may be harmful for perinatal outcomes and future child health, but the level of fetal cumulative exposure has been difficult to measure thus far. Here, we present maternal dietary caffeine intake during the last trimester and its correlation to caffeine content in newborn hair after birth. METHODS Maternal third trimester diets and dietary caffeine intake were prospectively collected in Kuopio Birth Cohort (KuBiCo) using a 160-item food frequency questionnaire (n = 2840). Newborn hair was collected within 48 h after birth and analyzed by high-resolution mass spectrometry (HRMS) for caffeine (n = 316). Correlation between dietary caffeine intake and neonatal hair caffeine content was evaluated from 203 mother-child pairs. RESULTS Mean dietary caffeine intake was 167 mg/days (95% CI 162-172 mg/days), of which coffee comprised 81%. Caffeine in the maternal diet and caffeine content in newborn hair correlated significantly (r = 0.50; p < 0.001). Older, multiparous, overweight women, and smokers had the highest caffeine levels in the maternal diet, as well as in their newborn babies' hair. CONCLUSION Caffeine exposure, estimated from newborn hair samples, reflects maternal third trimester dietary caffeine intake and introduces a new method to assess fetal cumulative caffeine exposure. Further studies to evaluate the effects of caffeine exposure on both perinatal and postnatal outcomes are warranted, since over 40% of pregnant women consume caffeine more than the current suggested recommendations (European Food Safety Association, EFSA recommendations).
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The regular consumption of coffee and development of type 2 diabetes mellitus. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Choi H, Koo S, Park HY. Maternal coffee intake and the risk of bleeding in early pregnancy: a cross-sectional analysis. BMC Pregnancy Childbirth 2020; 20:121. [PMID: 32085746 PMCID: PMC7035749 DOI: 10.1186/s12884-020-2798-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 02/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caffeine can easily cross the placenta, and maternal caffeine intake, thus, has an effect on fetal growth. However, it is still unclear whether coffee consumption is an independent risk factor for bleeding in early pregnancy. The objective of this study was to examine the association between pre-pregnancy coffee consumption patterns and the risk of bleeding in early pregnancy. METHODS A cross-sectional analysis was conducted among 3510 pregnant women from the Korean Pregnancy Outcome Study who underwent baseline examination and for whom the results of the pregnancy were available. Coffee consumption patterns before pregnancy were examined using a questionnaire. The participants were classified according to the frequency of coffee consumption into seldom (< 1 cup/week), light (< 1 cup/day), moderate (1 cup/day), and heavy coffee drinker (≥2 cups/day) groups. Bleeding in early pregnancy was defined as the occurrence of vaginal bleeding in the first 20 weeks of pregnancy. Multiple logistic regression models were applied to examine the association between pre-pregnancy coffee consumption and the risk of bleeding in early pregnancy, after adjusting for age, body mass index (BMI), systolic blood pressure, cigarette smoking and alcohol consumption behavior, previous and current physical activity levels, stress levels, history of depression, antenatal depressive symptoms during the first trimester, type of emesis, parity, and the number of livebirths, stillbirths, miscarriages, and abortions. RESULTS Women who were light, moderate, and heavy coffee drinkers before pregnancy had adjusted ORs of 1.086, 1.225, and 1.358, respectively, for bleeding in early pregnancy. In a fully adjusted model, heavy coffee drinkers showed a significantly higher risk of bleeding in early pregnancy, even in women aged 35 years and younger (OR 1.680) and in those with a normal body mass index (OR 1.389), who were at relatively low risk for pregnancy-related complications. CONCLUSIONS Our results showed that heavy coffee drinking was independently associated with a higher risk of bleeding in early pregnancy among pregnant Korean women, suggesting that caffeine intake before conception and during pregnancy should be reduced. Our study highlights the need for nutritional interventions for healthy coffee drinking among pregnant women in Korea.
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Affiliation(s)
- Hansol Choi
- Department of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control & Prevention, Cheongju, Republic of Korea
| | - Seul Koo
- Department of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control & Prevention, Cheongju, Republic of Korea
| | - Hyun-Young Park
- Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control & Prevention, Cheongju, Republic of Korea.
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Griffin I, Ibrahimou B, Navejar N, Aggarwal A, Myers K, Mauck D, Yusuf KK, Wudil UJ, Aliyu MH, Salihu HM. Maternal Caffeine Consumption and Racial Disparities in Fetal Telomere Length. Int J MCH AIDS 2020; 9:14-21. [PMID: 32123624 PMCID: PMC7031881 DOI: 10.21106/ijma.290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The identification of risk factors for shorter telomere length, especially during fetal development, would be important towards caffeine consumption recommendations for pregnant women on a global scale. The purpose of this study was to evaluate the association between caffeine intake and fetal telomere length as well as racial/ethnic differences in telomere length regardless of maternal caffeine consumption status. METHODS Caffeine intake was measured using a food frequency questionnaire (FFQ). Three generalized linear models (GLM) were compared based on binary categorical variables of caffeine levels using data mean value of 117.3 mg as cut-off; the World Health Organization (WHO) recommendations of 300 mg; and the American College of Obstetricians and Gynecologists (ACOG) recommendations of 200 mg. The association between caffeine consumption and telomere length (telomere to single-copy [T/S] ratio) was then assessed. RESULTS Among 57 maternal-fetal dyads, 77.2% reported less than 200 mg of caffeine (ACOG) and 89.5% less than 300 mg (WHO). Both WHO and ACOG models found that caffeine intake was significantly and positively associated with longer telomere length (p<0.05); and sodium (p<0.05). Other" race (p<0.001) and "white" race (p<0.001) were also significantly and positively associated with longer telomere length in the same models. Increasing maternal age shortened telomere length significantly in all models (p<0.001). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS Caffeine intake, maternal age, and race may be associated with alterations in fetal telomere length. This indicates that caffeine consumption during pregnancy may have long-term implications for fetal development. The racial/ethnic differences in telomere length found in this study warrant larger studies to further confirm these associations.
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Affiliation(s)
- Isabel Griffin
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, 11200 SW 8 Street #500, Miami, Florida 33174, USA
| | - Boubakari Ibrahimou
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, 11200 SW 8 Street #500, Miami, Florida 33174, USA
| | - Natasha Navejar
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, One Baylor Plaza, MS:411 Houston, TX 77030, USA
| | - Anjali Aggarwal
- Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Houston, Texas, 77098, USA
| | - Kristopher Myers
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, 11200 SW 8 Street #500, Miami, Florida 33174, USA
| | - Daniel Mauck
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, 11200 SW 8 Street #500, Miami, Florida 33174, USA
| | - Korede K Yusuf
- Adelphi University, College of Nursing and Public Health, One South Avenue, Garden City, NY 11530, USA
| | - Usman J Wudil
- Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, 2525 West End Ave, Suite 750, Nashville, TN 37203, USA
| | - Muktar H Aliyu
- Vanderbilt University Medical Center, Vanderbilt Institute for Global Health, 2525 West End Ave, Suite 750, Nashville, TN 37203, USA
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, One Baylor Plaza, MS:411 Houston, TX 77030, USA
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Mother-Infant Bonding and Emotional Availability at 12-Months of Age: The Role of Early Postnatal Bonding, Maternal Substance Use and Mental Health. Matern Child Health J 2019; 23:1686-1698. [PMID: 31529248 DOI: 10.1007/s10995-019-02809-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The quality of the mother-child relationship in the first year of life has far reaching implications across the life course (Bornstein in Annu Rev Psychol 65:121-158, 2014). Yet little is known about predictors of maternal bonding and emotional availability in early infancy. In this study we examined the extent to which postnatal bonding, maternal mental health, and substance use at 8-weeks postpartum predicted mother-infant bonding (self-report) and mother emotional availability (observational) at 12-months of age. METHODS Data were obtained from an Australian longitudinal cohort study of pregnancy (n = 308). Data were collected during pregnancy, at birth, and postnatally at 8-weeks and 12-months. RESULTS The results show strong continuity between postnatal bonding at 8-weeks and 12-months. Early postpartum stress and depression were associated with bonding at 12-months; however, the effect did not persist after adjustment for bonding at 8-weeks. Tobacco use at 8-weeks, but no other indicators of mental health, predicted lower emotional availability scores at 12-months. DISCUSSION Results suggest that the mother's felt bond to her child is stable across the first year of life and that early bonding is a more robust indicator of bonding at 12-months than a mother's mental health or substance use. These findings point to the importance of clinical and public health investments in establishing a strong bond between mother and child in the early postpartum period.
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Chen LW, Murrin CM, Mehegan J, Kelleher CC, Phillips CM. Maternal, but not paternal or grandparental, caffeine intake is associated with childhood obesity and adiposity: The Lifeways Cross-Generation Cohort Study. Am J Clin Nutr 2019; 109:1648-1655. [PMID: 31136661 PMCID: PMC7484488 DOI: 10.1093/ajcn/nqz019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Maternal caffeine intake is associated with adverse birth outcomes, but its long-term influence on offspring adiposity outcomes is not well studied. Furthermore, few studies have investigated paternal and grandparental caffeine intake in relation to offspring outcomes. OBJECTIVE To study the associations between maternal, paternal, and grandparental caffeine intake and offspring childhood adiposity. DESIGN The core study sample consists of 558 mother-child pairs from the Lifeways Study. Caffeine intake was derived from relevant food items in a self-administered validated food frequency questionnaire in early pregnancy. Children's body mass index (BMI) and waist circumference (WC) were measured at 5- and 9-y follow-up. Childhood overall and central obesity were defined as age- and sex-specific BMI z-score > International Obesity Task Force cut-off and WC z-score > 90th percentile, respectively. Multiple linear and logistic regressions were used to assess associations. RESULTS Study mothers had a mean age of 30.8 y and a mean prepregnancy BMI (kg/m2) of 23.7. In adjusted models, maternal caffeine intake was associated with a higher offspring BMI z-score [β (95% CI): 0.13 (0.06, 0.21) for year 5 and 0.17 (0.04, 0.29) for year 9; per 100 mg/d increment in maternal caffeine intake], WC z-score [β (95% CI): 0.09 (0.01, 0.17) for year 5 and 0.19 (0.05, 0.32) for year 9], and a higher risk of offspring overall obesity [OR (95% CI): 1.32 (1.11, 1.57) for year 5 and 1.44 (1.10, 1.88) for year 9] and central obesity [1.28 (1.02, 1.60) for year 5 and 1.62 (1.12, 2.34) for year 9]. The influence was stronger for coffee caffeine than tea caffeine. No consistent associations were observed for paternal and grandparental caffeine intake. CONCLUSIONS Maternal antenatal, but not paternal or grandparental, caffeine intake is associated with higher offspring adiposity and obesity risk at age 5 and 9 y, with stronger associations observed for coffee caffeine. This prospective observational study was registered at the ISRCTN Registry as ISRCTN16537904.
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Affiliation(s)
- Ling-Wei Chen
- Health Research Board Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Celine M Murrin
- Health Research Board Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - John Mehegan
- Health Research Board Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Cecily C Kelleher
- Health Research Board Centre for Diet and Health Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Republic of Ireland
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The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review. Nutrients 2019; 11:nu11040840. [PMID: 31013875 PMCID: PMC6521012 DOI: 10.3390/nu11040840] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Maternal nutrition in pregnancy has a key influence on optimum fetal health. Eating disorders (EDs) during pregnancy may have detrimental effects on fetal growth and the child’s early development. There is limited knowledge concerning the eating behavior, dietary intake and derived nutritional biomarkers as well as the nutrient supplementation in women with EDs during pregnancy. We performed a systematic review according to the PRISMA statement to synthesize current evidence in this field. Of N = 1203 hits, 13 full-texts were included in the qualitative synthesis. While women with current Binge Eating Disorder (BED) showed higher energy and fat intakes during pregnancy, women with a lifetime Anorexia Nervosa (AN), Bulimia Nervosa (BN) or both (AN + BN) had similar patterns of nutrient intake and dietary supplement use as healthy women. There is evidence, that women with a history of EDs have a sufficient diet quality and are more likely to be vegetarian. Dieting and bingeing improved substantially with pregnancy. The highlighted differences in the consumption of coffee/caffeine and artificially sweetened beverages as well as the elevated prevalence of iron deficiency anemia in women with a past or active ED during pregnancy might have an important impact on fetal development.
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Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters. Nutrients 2019; 11:nu11040806. [PMID: 30970673 PMCID: PMC6520888 DOI: 10.3390/nu11040806] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/27/2019] [Accepted: 04/03/2019] [Indexed: 11/17/2022] Open
Abstract
Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.
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R G A. Gestational caffeine exposure acts as a fetal thyroid-cytokine disruptor by activating caspase-3/BAX/Bcl-2/Cox2/NF-κB at ED 20. Toxicol Res (Camb) 2019; 8:196-205. [PMID: 30997021 PMCID: PMC6415617 DOI: 10.1039/c8tx00227d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 11/15/2018] [Indexed: 12/26/2022] Open
Abstract
The objective of this examination was to explore the impact of gestational caffeine (1,3,7-trimethylxanthine) exposure on the maternofetal thyroid axis and fetal thyroid-cytokine communications during gestation. Pregnant rats (Rattus norvegicus) were intraperitoneally administered caffeine (120 or 150 mg kg-1) from gestation day (GD) 1 to 20. Both doses of caffeine resulted in maternal hyperthyroidism, whereas the elevation in the concentration of serum free triiodothyronine (FT3) and free thyroxine (FT4) was related to a depletion in the level of TSH at GD 20. Maternal body weight gain and food consumption were markedly increased, while fetal body weight was significantly reduced. These alterations caused fetal hypothyroidism and several pathological lesions in the fetal thyroid gland including a vacuolar colloid, destructive degeneration, atrophy and hyperplasia at embryonic day (ED) 20. The abnormalities in the fetal thyroid gland seemed to depend on the activation of caspase-3, Bcl-2, BAX, Cox2, and NF-κB mRNA expression. Both maternal caffeine doses caused a marked attenuation in the values of fetal serum GH, IGF-II, VEGF, TGF-β, TNF-α, IL-1β, IL-6, leptin and MCP-1, and a noticeable elevation in the value of fetal serum adiponectin at ED 20. Thus, gestational caffeine exposure might disrupt the fetal thyroid-cytokine axis.
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Affiliation(s)
- Ahmed R G
- Division of Anatomy and Embryology , Zoology Department , Faculty of Science , Beni-Suef University , Beni-Suef , Egypt . ;
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Mousa A, Naqash A, Lim S. Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence. Nutrients 2019; 11:nu11020443. [PMID: 30791647 PMCID: PMC6413112 DOI: 10.3390/nu11020443] [Citation(s) in RCA: 197] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 01/10/2023] Open
Abstract
Nutritional status during pregnancy can have a significant impact on maternal and neonatal health outcomes. Requirements for macronutrients such as energy and protein increase during pregnancy to maintain maternal homeostasis while supporting foetal growth. Energy restriction can limit gestational weight gain in women with obesity; however, there is insufficient evidence to support energy restriction during pregnancy. In undernourished women, balanced energy/protein supplementation may increase birthweight whereas high protein supplementation could have adverse effects on foetal growth. Modulating carbohydrate intake via a reduced glycaemic index or glycaemic load diet may prevent gestational diabetes and large-for-gestational-age infants. Certain micronutrients are also vital for improving pregnancy outcomes, including folic acid to prevent neural tube defects and iodine to prevent cretinism. Newly published studies support the use of calcium supplementation to prevent hypertensive disorders of pregnancy, particularly in women at high risk or with low dietary calcium intake. Although gaps in knowledge remain, research linking nutrition during pregnancy to maternofoetal outcomes has made dramatic advances over the last few years. In this review, we provide an overview of the most recent evidence pertaining to macronutrient and micronutrient requirements during pregnancy, the risks and consequences of deficiencies and the effects of supplementation on pregnancy outcomes.
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Affiliation(s)
- Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia.
| | - Amreen Naqash
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, Jammu and Kashmir 190006, India.
| | - Siew Lim
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia.
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Abstract
Caffeine is the most consumed active stimulant. About 80% of pregnant women consume caffeine orally on a daily basis. Many reports indicated consumption of >200 mg caffeine during pregnancy could increase the likelihood of miscarriage. In this article, we developed a pregnancy physiological-based pharmacokinetic/pharmacodynamic (PBPK/PD) model for caffeine to examine association between maternal caffeine consumption during pregnancy and caffeine plasma levels at doses lower and higher than 200 mg to predict changes in caffeine concentrations across the 3 trimesters, and to predict associated changes in caffeine PD parameters. Two models were successfully developed using GastroPlus software, a nonpregnant model for validation purposes and a pregnant model for validation and prediction of maternal caffeine plasma concentrations following single and multiple dosing. Using observed and predicted data, we were able to validate and simulate PK changes of caffeine in nonpregnant women and the PD effect of caffeine on certain enzymes and catecholamines associated with caffeine intake. Furthermore, the pregnancy PBPK model successfully predicted changes in caffeine PK across the three trimesters. Caffeine increased exposure during pregnancy was related to reduced activity of caffeine metabolizing enzyme CYP1A2. The model also predicted increased levels of caffeine in the fetoplacental compartment (FPC) due to increased maternal caffeine plasma concentrations. Increased caffeine levels in maternal blood was accompanied by greater inhibition of the phosphodiesterase enzyme, higher cyclic adenosine monophosphate, and greater increase of epinephrine levels, which could increase the risk of pregnancy loss. The application of the developed PBPK model to predict the PD effect could provide a useful tool to help define potential cut-offs for caffeine intake in various stages of pregnancy.
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Koletzko B, Cremer M, Flothkötter M, Graf C, Hauner H, Hellmers C, Kersting M, Krawinkel M, Przyrembel H, Röbl-Mathieu M, Schiffner U, Vetter K, Weißenborn A, Wöckel A. Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network. Geburtshilfe Frauenheilkd 2018; 78:1262-1282. [PMID: 30655650 PMCID: PMC6294644 DOI: 10.1055/a-0713-1058] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with recommendations on a preconception lifestyle. The recommendations address body weight before conception, weight gain in pregnancy, energy and nutritional requirements and diet (including a vegetarian/vegan diet), the supplements folic acid/folate, iodine, iron and docosahexaenoic acid (DHA), protection against food-borne illnesses, physical activity before and during pregnancy, alcohol, smoking, caffeinated drinks, oral and dental hygiene and the use of medicinal products. Preparation for breast-feeding is recommended already during pregnancy. Vaccination recommendations for women planning a pregnancy are also included. These practical recommendations of the Germany-wide Healthy Start - Young Family Network are intended to assist all professional groups that counsel women and couples wishing to have children and during pregnancy with uniform, scientifically-based and practical information.
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Affiliation(s)
- Berthold Koletzko
- Kinderklinik und Kinderpoliklinik, Dr. von Haunersches Kinderspital, LMU – Ludwig-Maximilians-Universität, München, Germany
- Deutsche Gesellschaft für Kinder- und Jugendheilkunde e. V. (DGKJ), Berlin, Germany
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Monika Cremer
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Maria Flothkötter
- Netzwerk Gesund ins Leben/Bundeszentrum für Ernährung (BZfE) in der Bundesanstalt für Landwirtschaft und Ernährung (BLE), Bonn, Germany
| | - Christine Graf
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Deutsche Sporthochschule Köln, Köln, Germany
| | - Hans Hauner
- Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Claudia Hellmers
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Hochschule Osnabrück, Osnabrück, Germany
- Deutsche Gesellschaft für Hebammenwissenschaft e. V. (DGHWi), Münster, Germany
| | - Mathilde Kersting
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Forschungsdepartment Kinderernährung, Klinik für Kinder- und Jugendmedizin, Universitätsklinikum der Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Krawinkel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Institut für Ernährungswissenschaft, Justus-Liebig-Universität Gießen, Gießen, Germany
- Deutsche Gesellschaft für Ernährung e. V. (DGE), Bonn, Germany
| | - Hildegard Przyrembel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
| | - Marianne Röbl-Mathieu
- Mitglied der Ständigen Impfkommission am Robert Koch-Institut (STIKO), Berlin, Germany
| | - Ulrich Schiffner
- Poliklinik für Zahnerhaltung und Präventive Zahnheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
- Deutsche Gesellschaft für Kinderzahnheilkunde e. V. (DGKiZ), Würzburg, Germany
| | - Klaus Vetter
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Nationale Stillkommission, Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Anke Weißenborn
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Bundesinstitut für Risikobewertung (BfR), Berlin, Germany
| | - Achim Wöckel
- Mitglied im wissenschaftlichen Beirat des Netzwerks Gesund ins Leben, Bonn, Germany
- Frauenklinik und Poliklinik Universitätsklinikum Würzburg, Würzburg, Germany
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Biases Inherent in Studies of Coffee Consumption in Early Pregnancy and the Risks of Subsequent Events. Nutrients 2018; 10:nu10091152. [PMID: 30142937 PMCID: PMC6163788 DOI: 10.3390/nu10091152] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/18/2018] [Accepted: 08/21/2018] [Indexed: 12/23/2022] Open
Abstract
Consumption of coffee by women early in their pregnancy has been viewed as potentially increasing the risk of miscarriage, low birth weight, and childhood leukemias. Many of these reports of epidemiologic studies have not acknowledged the potential biases inherent in studying the relationship between early-pregnancy-coffee consumption and subsequent events. I discuss five of these biases, recall bias, misclassification, residual confounding, reverse causation, and publication bias. Each might account for claims that attribute adversities to early-pregnancy-coffee consumption. To what extent these biases can be avoided remains to be determined. As a minimum, these biases need to be acknowledged wherever they might account for what is reported.
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Energy drink exposures reported to Texas poison centers: Analysis of adverse incidents in relation to total sales, 2010–2014. Regul Toxicol Pharmacol 2018; 97:1-14. [DOI: 10.1016/j.yrtph.2018.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/18/2017] [Accepted: 05/10/2018] [Indexed: 12/21/2022]
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García-Franco AL, Baeyens Fernández JA, Bailón Muñoz E, Iglesias Piñeiro MJ, Cura González ID, Del Moral AO, Landa Goñi J, Alonso Coello P, Arribas Mir L. Actividades preventivas en la mujer. Actualización PAPPS 2018. Aten Primaria 2018; 50 Suppl 1:125-146. [PMID: 29866353 PMCID: PMC6836928 DOI: 10.1016/s0212-6567(18)30366-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
| | | | - Emilia Bailón Muñoz
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Universitario de Albaycín, Granada
| | | | - Isabel Del Cura González
- Especialista en Medicina Familiar y Comunitaria, Unidad de Investigación, Gerencia Asistencial de Atención Primaria, Madrid
| | | | - Jacinta Landa Goñi
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Emisora, Pozuelo de Alarcón, Madrid
| | - Pablo Alonso Coello
- Especialista en Medicina Familiar y Comunitaria, Centro Cochrane Iberoamericano (CIBERESP-IIB Sant Pau), Barcelona
| | - Lorenzo Arribas Mir
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Universitario La Chana, Granada
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Aagaard SK, Larsen A, Andreasen MF, Lesnikova I, Telving R, Vestergaard AL, Tørring N, Uldbjerg N, Bor P. Prevalence of xenobiotic substances in first-trimester blood samples from Danish pregnant women: a cross-sectional study. BMJ Open 2018; 8:e018390. [PMID: 29502084 PMCID: PMC5855249 DOI: 10.1136/bmjopen-2017-018390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence of xenobiotic substances, such as caffeine, nicotine and illicit drugs (eg, cannabis and cocaine), in blood samples from first-trimester Danish pregnant women unaware of the screening. DESIGN A cross-sectional study examined 436 anonymised residual blood samples obtained during 2014 as part of the nationwide prenatal first-trimester screening programme. The samples were analysed by ultra performance liquid chromatography with high-resolution time-of-flight mass spectrometry. SETTING An antenatal clinic in a Danish city with 62 000 inhabitants, where >95% of pregnant women joined the screening programme. PRIMARY AND SECONDARY OUTCOME MEASURES The prevalence and patterns of caffeine, nicotine, medication and illicit drug intake during the first trimester of pregnancy. RESULTS The prevalence of prescription and over-the-counter drug detection was 17.9%, including acetaminophen (8.9%) and antidepressants (3.0%), of which citalopram (0.9%) was the most frequent. The prevalence of illegal drugs, indicators of smoking (nicotine/cotinine) and caffeine was 0.9%, 9.9%, and 76.4%, respectively. Only 17.4% of women had no substance identified in their sample. CONCLUSIONS This study emphasises the need for further translational studies investigating lifestyle habits during pregnancy, as well as the underlying molecular mechanisms through which xenobiotic substances may affect placental function and fetal development.
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Affiliation(s)
- Sissel Kramer Aagaard
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Agnete Larsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Mette Findal Andreasen
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | | | - Rasmus Telving
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
| | - Anna Louise Vestergaard
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Niels Tørring
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Pinar Bor
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
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Lyngsø J, Ramlau-Hansen CH, Bay B, Ingerslev HJ, Hulman A, Kesmodel US. Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose-response meta-analysis. Clin Epidemiol 2017; 9:699-719. [PMID: 29276412 PMCID: PMC5733907 DOI: 10.2147/clep.s146496] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim was to investigate whether coffee or caffeine consumption is associated with reproductive endpoints among women with natural fertility (ie, time to pregnancy [TTP] and spontaneous abortion [SAB]) and among women in fertility treatment (ie, clinical pregnancy rate or live birth rate). Design This study was a systematic review and dose-response meta-analysis including data from case-control and cohort studies. Methods An extensive literature search was conducted in MEDLINE and Embase, with no time and language restrictions. Also, reference lists were searched manually. Two independent reviewers assessed the manuscript quality using the Newcastle-Ottawa Scale (NOS). A two-stage dose-response meta-analysis was applied to assess a potential association between coffee/caffeine consumption and the outcomes: TTP, SAB, clinical pregnancy, and live birth. Heterogeneity between studies was assessed using Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger's regression test. Results The pooled results showed that coffee/caffeine consumption is associated with a significantly increased risk of SAB for 300 mg caffeine/day (relative risk [RR]: 1.37, 95% confidence interval [95% CI]: 1.19; 1.57) and for 600 mg caffeine/day (RR: 2.32, 95% CI: 1.62; 3.31). No association was found between coffee/caffeine consumption and outcomes of fertility treatment (based on two studies). No clear association was found between exposure to coffee/caffeine and natural fertility as measured by fecundability odds ratio (based on three studies) or waiting TTP (based on two studies). Conclusion Results from this meta-analysis support the growing evidence of an association between coffee/caffeine intake and the risk of SAB. However, viewing the reproductive capacity in a broader perspective, there seems to be little, if any, association between coffee/caffeine consumption and fecundity. In general, results from this study are supportive of a precautionary principle advised by health organizations such as European Food Safety Authority (EFSA) and World Health Organization (WHO), although the advised limit of a maximum of two to three cups of coffee/200-300 mg caffeine per day may be too high.
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Affiliation(s)
- Julie Lyngsø
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus
| | | | - Bjørn Bay
- The Fertility Clinic, Regional Horsens Hospital, Horsens
| | | | - Adam Hulman
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus.,Danish Diabetes Academy, Odense
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Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 2017; 359:j5024. [PMID: 29167102 PMCID: PMC5696634 DOI: 10.1136/bmj.j5024] [Citation(s) in RCA: 421] [Impact Index Per Article: 60.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objectives To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes.Design Umbrella review of the evidence across meta-analyses of observational and interventional studies of coffee consumption and any health outcome.Data sources PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references.Eligibility criteria for selecting studies Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings. Studies of genetic polymorphisms for coffee metabolism were excluded.Results The umbrella review identified 201 meta-analyses of observational research with 67 unique health outcomes and 17 meta-analyses of interventional research with nine unique outcomes. Coffee consumption was more often associated with benefit than harm for a range of health outcomes across exposures including high versus low, any versus none, and one extra cup a day. There was evidence of a non-linear association between consumption and some outcomes, with summary estimates indicating largest relative risk reduction at intakes of three to four cups a day versus none, including all cause mortality (relative risk 0.83 (95% confidence interval 0.79 to 0.88), cardiovascular mortality (0.81, 0.72 to 0.90), and cardiovascular disease (0.85, 0.80 to 0.90). High versus low consumption was associated with an 18% lower risk of incident cancer (0.82, 0.74 to 0.89). Consumption was also associated with a lower risk of several specific cancers and neurological, metabolic, and liver conditions. Harmful associations were largely nullified by adequate adjustment for smoking, except in pregnancy, where high versus low/no consumption was associated with low birth weight (odds ratio 1.31, 95% confidence interval 1.03 to 1.67), preterm birth in the first (1.22, 1.00 to 1.49) and second (1.12, 1.02 to 1.22) trimester, and pregnancy loss (1.46, 1.06 to 1.99). There was also an association between coffee drinking and risk of fracture in women but not in men.Conclusion Coffee consumption seems generally safe within usual levels of intake, with summary estimates indicating largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm. Robust randomised controlled trials are needed to understand whether the observed associations are causal. Importantly, outside of pregnancy, existing evidence suggests that coffee could be tested as an intervention without significant risk of causing harm. Women at increased risk of fracture should possibly be excluded.
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Affiliation(s)
- Robin Poole
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Oliver J Kennedy
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Paul Roderick
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
| | - Jonathan A Fallowfield
- Medical Research Council/University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, EH16 4TJ, UK
| | - Peter C Hayes
- Medical Research Council/University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh, EH16 4TJ, UK
| | - Julie Parkes
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Southampton, Hampshire SO16 6YD, UK
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