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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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Mayrink J, Leite DF, Nobrega GM, Costa ML, Cecatti JG. Prediction of pregnancy-related hypertensive disorders using metabolomics: a systematic review. BMJ Open 2022; 12:e054697. [PMID: 35470187 PMCID: PMC9039389 DOI: 10.1136/bmjopen-2021-054697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To determine the accuracy of metabolomics in predicting hypertensive disorders in pregnancy. DESIGN Systematic review of observational studies. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA An electronic literature search was performed in June 2019 and February 2022. Two researchers independently selected studies published between 1998 and 2022 on metabolomic techniques applied to predict the condition; subsequently, they extracted data and performed quality assessment. Discrepancies were dealt with a third reviewer. The primary outcome was pre-eclampsia. Cohort or case-control studies were eligible when maternal samples were taken before diagnosis of the hypertensive disorder. STUDY APPRAISAL AND SYNTHESIS METHODS Data on study design, maternal characteristics, how hypertension was diagnosed, metabolomics details and metabolites, and accuracy were independently extracted by two authors. RESULTS Among 4613 initially identified studies on metabolomics, 68 were read in full text and 32 articles were included. Studies were excluded due to duplicated data, study design or lack of identification of metabolites. Metabolomics was applied mainly in the second trimester; the most common technique was liquid-chromatography coupled to mass spectrometry. Among the 122 different metabolites found, there were 23 amino acids and 21 fatty acids. Most of the metabolites were involved with ammonia recycling; amino acid metabolism; arachidonic acid metabolism; lipid transport, metabolism and peroxidation; fatty acid metabolism; cell signalling; galactose metabolism; nucleotide sugars metabolism; lactose degradation; and glycerolipid metabolism. Only citrate was a common metabolite for prediction of early-onset and late-onset pre-eclampsia. Vitamin D was the only metabolite in common for pre-eclampsia and gestational hypertension prediction. Meta-analysis was not performed due to lack of appropriate standardised data. CONCLUSIONS AND IMPLICATIONS Metabolite signatures may contribute to further insights into the pathogenesis of pre-eclampsia and support screening tests. Nevertheless, it is mandatory to validate such methods in larger studies with a heterogeneous population to ascertain the potential for their use in clinical practice. PROSPERO REGISTRATION NUMBER CRD42018097409.
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Affiliation(s)
- Jussara Mayrink
- Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Debora F Leite
- Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Guilherme M Nobrega
- Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Maria Laura Costa
- Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
| | - Jose Guilherme Cecatti
- Department of Obstetrics and Gynecology, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil
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Hinkle SN, Gleason JL, Yisahak SF, Zhao SK, Mumford SL, Sundaram R, Grewal J, Grantz KL, Zhang C. Assessment of Caffeine Consumption and Maternal Cardiometabolic Pregnancy Complications. JAMA Netw Open 2021; 4:e2133401. [PMID: 34748005 PMCID: PMC8576579 DOI: 10.1001/jamanetworkopen.2021.33401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE Women are recommended to limit caffeine consumption to less than 200 mg per day based on risks to fetal health. Impacts of caffeine on maternal health remain unclear. OBJECTIVE To determine whether caffeinated-beverage intake and plasma caffeine and paraxanthine are associated with cardiometabolic complications in pregnancy (ie, gestational diabetes [GDM], preeclampsia, and gestational hypertension [GH]). DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from a longitudinal pregnancy cohort study from the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons (2009-2013). This post hoc secondary analysis of 2802 pregnant women without major chronic conditions enrolled at 12 US clinical sites was completed in 2021. The final sample for caffeinated beverage analyses included 2583 women. After excluding women who did not consent to have their biospecimens stored for future research (n = 54), plasma caffeine analyses included 2529 women. Analyses of caffeine consumption and fasting cardiometabolic profiles included 319 women. EXPOSURES Daily total caffeine intake was estimated at 10 to 13 gestational weeks and 16 to 22 gestational weeks based on self-reported past week intake of caffeinated coffee, tea, soda, and energy drinks. Plasma caffeine and paraxanthine were measured in specimens collected at 10 to 13 weeks. MAIN OUTCOMES AND MEASURES Clinical diagnoses of GDM, preeclampsia, GH, glucose concentrations from GDM screening, and blood pressure were extracted from medical records. RESULTS Participants had a mean (SD) age of 28.1 (5.5) years and 422 participants (16.3%) were Asian/Pacific Islander women, 741 (28.9%) were Hispanic women, 717 (27.8%) were non-Hispanic Black women, and 703 (27.2%) were non-Hispanic White women. At 10 to 13 weeks, 1073 women (41.5%) reported consuming no caffeinated beverages, 1317 (51.0%) reported consuming 1 mg/d to 100 mg/d, 173 (6.7%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d. At 16 to 22 weeks, 599 women (23.6%) reported consuming no caffeinated beverages, 1734 (68.3%) reported consuming 1 mg/d to 100 mg/d, 186 (7.3%) reported consuming 101 mg/d to 200 mg/d, and 20 (0.8%) reported consuming more than 200 mg/d caffeinated beverages. Intake at 16 to 22 weeks was associated with lower GDM risk and lower glucose concentrations (1 mg/d to 100 mg/d vs none: relative risk, 0.53 [95% CI, 0.35 to 0.80]; β, -2.7 mg/dL [95% CI, -5.4 mg/dL to 0 mg/dL]) and lower C-reactive protein and C-peptide concentrations and favorable lipid profiles. Total plasma caffeine and paraxanthine at 10 to 13 weeks was inversely associated with glucose (quartile 4 vs quartile 1: β = -3.8 mg/dL [95% CI, -7.0 mg/dL to -0.5 mg/dL]; trend of P = .01). No associations were observed with preeclampsia or GH. CONCLUSIONS AND RELEVANCE In this cohort study, second trimester caffeinated beverage intake within current recommendations was associated with lower GDM risk, but not preeclampsia or GH. These findings may be reassuring for women with moderate caffeine intake.
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Affiliation(s)
- Stefanie N. Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jessica L. Gleason
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Samrawit F. Yisahak
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Sifang Kathy Zhao
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Sunni L. Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Jagteshwar Grewal
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Katherine L. Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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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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Abstract
AbstractThe WHO reported that high blood pressure (BP) is one of the primary causes of death worldwide. Hypertension (HPT) is a major risk factor for CVD and related diseases as well as for diseases, leading to a considerable increase in cardiovascular risk. Since BP response could also be influenced by caffeine, which is widely consumed with coffee and other items, it is important to define the possible effects associated with caffeine intake. The most recent findings aimed at clarifying the role of caffeine consumption on BP and HPT risk/incidence are conflicting and difficult to interpret. Therefore, in the present narrative review, we aimed to examine various methodological inaccuracies/aspects and factors that make studies difficult to be compared, in order to obtain a single consensus on the effects of caffeine intake on the risk of BP and HPT. We observed that this heterogeneity in results could be due to the presence of: (i) several variables affecting BP (such as age, sex, genetic and lifestyle aspects); (ii) different caffeine content of food and beverages; and (iii) caffeine metabolism. Moreover, different methodological aspects in the evaluation of daily dietary caffeine intake and in the BP measurement could add some other bias in the interpretation of results. Therefore, it is mandatory to consider all methodological aspects and confounding factors to generate a standardised methodology in order to increase cross-study consistency and minimise confounding effects of different variables on the relationship between BP response and HPT risk/incidence after caffeine intake.
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Amosco MD, Tavera GR, Villar VAM, Naniong JMA, David-Bustamante LMG, Williams SM, Jose PA, Palmes-Saloma CP. Non-additive effects of ACVR2A in preeclampsia in a Philippine population. BMC Pregnancy Childbirth 2019; 19:11. [PMID: 30621627 PMCID: PMC6323705 DOI: 10.1186/s12884-018-2152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Multiple interrelated pathways contribute to the pathogenesis of preeclampsia, and variants in susceptibility genes may play a role among Filipinos, an ethnically distinct group with high prevalence of the disease. The objective of this study was to examine the association between variants in maternal candidate genes and the development of preeclampsia in a Philippine population. METHODS A case-control study involving 29 single nucleotide polymorphisms (SNPs) in 21 candidate genes was conducted in 150 patients with preeclampsia (cases) and 175 women with uncomplicated normal pregnancies (controls). Genotyping for the GRK4 and DRD1 gene variants was carried out using the TaqMan Assay, and all other variants were assayed using the Sequenom MassARRAY Iplex Platform. PLINK was used for SNP association testing. Multilocus association analysis was performed using multifactor dimensionality reduction (MDR) analysis. RESULTS Among the clinical factors, older age (P < 1 × 10-4), higher BMI (P < 1 × 10-4), having a new partner (P = 0.006), and increased time interval from previous pregnancy (P = 0.018) associated with preeclampsia. The MDR algorithm identified the genetic variant ACVR2A rs1014064 as interacting with age and BMI in association with preeclampsia among Filipino women. CONCLUSIONS The MDR algorithm identified an interaction between age, BMI and ACVR2A rs1014064, indicating that context among genetic variants and demographic/clinical factors may be crucial to understanding the pathogenesis of preeclampsia among Filipino women.
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Affiliation(s)
- Melissa D. Amosco
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
- Department of Obstetrics and Gynecology, Philippine General Hospital - University of the Philippines, Taft Avenue, 1000 Manila, Philippines
| | - Gloria R. Tavera
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, School of Medicine, Cleveland, OH 44106 USA
| | - Van Anthony M. Villar
- Division of Renal Diseases & Hypertension, Department of Medicine, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
| | - Justin Michael A. Naniong
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
| | - Lara Marie G. David-Bustamante
- Department of Obstetrics and Gynecology, Philippine General Hospital - University of the Philippines, Taft Avenue, 1000 Manila, Philippines
| | - Scott M. Williams
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, School of Medicine, Cleveland, OH 44106 USA
| | - Pedro A. Jose
- Division of Renal Diseases & Hypertension, Department of Medicine, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
- Department of Pharmacology and Physiology, The George Washington University of School of Medicine & Health Sciences, Washington, DC, 20037 USA
| | - Cynthia P. Palmes-Saloma
- National Institute of Molecular Biology and Biotechnology, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
- Philippine Genome Center, National Science Complex, University of the Philippines, Diliman, 1101 Quezon City, Philippines
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