Introduction | Dr. Anutosh Chakraborty
Drinking a few cups of coffee a day has long been considered safe during pregnancy, but new research finds that even this small amount of caffeine can double the risk of a woman's miscarriage.
Doctors are divided over what this means for pregnant women, with some advising to avoid caffeine altogether and others saying that low-alcohol beverages are still relatively safe.
Previous studies have linked caffeine with an increased risk of miscarriage, but they have focused on higher levels and linking has been controversial, with some experts saying the study did not address morning sickness. Nausea and vomiting of morning sickness, caused by high hormones, are often a sign of a reduced risk of miscarriage - and it can also lead women to stop drinking their regular coffee or other caffeinated beverages. Worryingly, a decrease in caffeine among these women may make it appear that caffeine is associated with pregnancy.
Towards the end of the puzzle, a team led by Dr. De-Kun Li, a scientist at Kaiser Permanente in Oakland, California, directed one of the main examinations to address morning sickness. They concluded that the daily habit of drinking 200 milligrams of caffeine - an amount normally found only in two cups of coffee - greatly increased the risk of miscarriage.
"In the event that women are pregnant or expecting to become pregnant they should contemplate stopping caffeine utilization, basically during the essential trimester when most pregnancies occur," Li said.
"If they really need to drink, they should reduce one cup of coffee a day," he added...
Coffee, tea, and soda pose similar risks during pregnancy
The source of caffeine - whether it came from coffee, tea, or soda - made no difference. But one thing to consider is that a cup of coffee can have different amounts of caffeine depending on how it is made, and some brands contain more addictive chemicals than others. High-quality coffee made with Starbucks, for example, packs 270 mg of caffeine. The long latte on the chain, however, contains 75 mg.
In the examination, distributed in Monday's issue of the American Journal of Obstetrics and Gynecology, Li's group met 1,063 ladies in the San Francisco region who became pregnant between 1996 and 1998 about their caffeine intake. While 164 ladies drank 200 mg of caffeine or all the more every day, 635 devoured caffeine however under 200 mg. The remaining 264 women said they did not consume caffeine.
In all, 172 women had a miscarriage. The risk of miscarriage was more than double that of women who consumed 200 mg or more of caffeine, with 25 percent suffering from diarrhea compared to only 12 percent of women who did not consume caffeine. Low-dose caffeine drinkers also appeared to have a higher risk of miscarriage, but the practice was statistically insignificant, meaning researchers were unable to rule out that it was simply a matter of chance.
2-cup cutoff point
Li said the 200 mg limit could be considered a cutting point when the risk of a miscarriage first appeared because the average consumption of the high caffeine diet group was 301 mg per day. This means that half of these women were drinking less than 301 mg daily, so those who drank too much may not have bothered the results.
To determine the effect of morning sickness on the results, Li's group looked at differently from women who were nauseous and vomiting and those who did not. The risk of miscarriage remained in both groups as long as their daily caffeine intake increased by more than 200 mg. What's more, specialists took a gander at ladies who diminished their caffeine utilization during their pregnancy and the individuals who didn't and tracked down that the danger of unsuccessful labor actually stayed for individuals who consumed 200 mg or a more prominent measure of caffeine every day.
The increased risk remained even after adjustments to other factors that may increase the risk of miscarriage, such as old age, previous pregnancies, smoking, and alcohol abuse.
Although it is not known exactly how caffeine can cause diarrhea, one theory holds that it restricts blood flow to the placenta, which can adversely affect the developing fetus, says Li.
Overall, caffeine is not a major cause of miscarriage, which occurs in 20 percent of known pregnancies. More than 60 percent of these miscarriages are due to chromosomal defects in the fetus that are beyond the mother's control.
The doctors split up
Doctors on the frontlist were classified as caffeine. Dr. Tracy Flanagan, obstetrician/gynecologist, and overseer of ladies' wellbeing in North California at Kaiser Permanente said that dependent on the consequences of the investigation, she would put more emphasis on advising her pregnant patients to limit coffee and other caffeinated beverages.
Flanagan said that along with other prenatal tips, such as taking folic acid supplements, not drinking alcohol, and not smoking, you will increase your caffeine intake to no more than one cup of coffee a day or cut it completely.
But Dr. Katharine O'Connell, a gynecologist at Columbia University, remains uncertain. He said the study would not be enough to change his advice to patients and doubted that we would reverse the current recommendations from the American College of Obstetricians also, Gynecologists that caffeine admission during pregnancy is protected (ACOG said it doesn't remark on individual examinations).
"I can tell my patients that two cups of coffee day by day should be ready," O'Connell said.
He also noted that the findings were interesting because previous studies linking caffeine with an increased risk of miscarriage included higher prices - equivalent to several cups of coffee a day. But current research shows that risk starts at a low cost, so this may require further investigation, he said.
It is too early to receive an alarm
It is too early to announce the alarm, according to O'Connell. Major studies confirming the risk of miscarriage would be needed before these low caffeine levels were considered unhealthy, she said.
Without a final word on the matter, expectant mothers may hear conflicting advice from their doctors and simply decide for themselves that lattes are important even with the slightest risk.
A coffee lover and the mother of daughters in San Francisco said giving up java while pregnant was possible and she should know. After her first attempt at pregnancy seven years ago ended with a miscarriage, Plotkin-Oren, 35, moved to cold Turkey during the next pregnancy.
While there is no way to know if her 3 to 4 cups of coffee a day contributed to a miscarriage, she said she decided to end her diet three times during her pregnancy as part of her overall health plan and each led to a successful birth.
Plotkin-Oren missed the social atmosphere of meeting coffee friends and had a headache due to caffeine withdrawal, but overall he found it easy to kick the habit. "It wasn't that hard because I was determined to do my best to make sure I got pregnant successfully," she said.
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