title: Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: the Generation R Study.
abstract: BACKGROUND
  Caffeine is a widely used and accepted pharmacologically active substance. The effect of caffeine intake during pregnancy on fetal growth and development is still unclear.
  
  
  OBJECTIVE
  We examined the associations of maternal caffeine intake, on the basis of coffee and tea consumption, with fetal growth characteristics measured in each trimester of pregnancy and the risks of adverse birth outcomes.
  
  
  METHODS
  Associations were studied in 7346 pregnant women participating in a population-based prospective cohort study from early pregnancy onward in the Netherlands (2001-2005). Caffeine intake in the first, second, and third trimesters was on the basis of coffee and tea consumption and was assessed by questionnaires. Fetal growth characteristics were repeatedly measured by ultrasound. Information about birth outcomes was obtained from hospital records.
  
  
  RESULTS
  We observed no consistent associations of caffeine intake with fetal head circumference or estimated fetal weight in any trimester. Higher caffeine intake was associated with smaller first-trimester crown-rump length, second- and third-trimester femur length, and birth length (P for trend <0.05). Offspring of mothers who consumed > or =6 caffeine units/d tended to have increased risks of small-for-gestational-age infants at birth.
  
  
  CONCLUSIONS
  Our results suggest that caffeine intake of > or =6 units/d during pregnancy is associated with impaired fetal length growth. Caffeine exposure might preferentially adversely affect fetal skeletal growth. Further studies are needed to assess these associations in non-European populations and to assess the postnatal consequences.
authors.affiliation: Departments of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bakker
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Obradov
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D002110:Caffeine / Q000008:administration & dosage* / Q000009:adverse effects*; D003069:Coffee / Q000009:adverse effects; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D047109:Fetal Development / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013662:Tea / Q000009:adverse effects; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D003069:Coffee; D013662:Tea; D002110:Caffeine