title: Intake of Caffeinated Soft Drinks before and during Pregnancy, but Not Total Caffeine Intake, Is Associated with Increased Cerebral Palsy Risk in the Norwegian Mother and Child Cohort Study.
abstract: Postnatal administration of caffeine may reduce the risk of cerebral palsy (CP) in vulnerable low-birth-weight neonates. The effect of antenatal caffeine exposure remains unknown.
  
  
  
  We investigated the association of intake of caffeine by pregnant women and risk of CP in their children.
  
  
  
  The study was based on The Norwegian Mother and Child Cohort Study, comprising >100,000 live-born children, of whom 222 were subsequently diagnosed with CP. Mothers reported their caffeine consumption in questionnaires completed around pregnancy week 17 (102,986 mother-child pairs), week 22 (87,987 mother-child pairs), and week 30 (94,372 mother-child pairs). At week 17, participants were asked about present and prepregnancy consumption. We used Cox regression models to estimate associations between exposure [daily servings (1 serving = 125 mL) of caffeinated coffee, tea, and soft drinks and total caffeine consumption] and CP in children, with nonconsumers as the reference group. Models included adjustment for maternal age and education, medically assisted reproduction, and smoking, and for each source of caffeine, adjustments were made for the other sources.
  
  
  
  Total daily caffeine intake before and during pregnancy was not associated with CP risk. High consumption (≥6 servings/d) of caffeinated soft drinks before pregnancy was associated with an increased CP risk (HR: 1.9; 95% CI: 1.2, 3.1), and children of women consuming 3-5 daily servings of caffeinated soft drinks during pregnancy weeks 13-30 also had an increased CP risk (HR: 1.7; 95% CI: 1.1, 2.8). A mean daily consumption of 51-100 mg caffeine from soft drinks during the first half of pregnancy was associated with a 1.9-fold increased risk of CP in children (HR: 1.9; 95% CI: 1.1, 3.6).
  
  
  
  Maternal total daily caffeine consumption before and during pregnancy was not associated with CP risk in children. The observed increased risk with caffeinated soft drinks warrants further investigation.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Domain for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway; mette.tollanes@uib.no.
authors.forename: Mette C
authors.initials: MC
authors.lastname: Tollånes
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark;
authors.forename: Katrine
authors.initials: K
authors.lastname: Strandberg-Larsen
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC;
authors.forename: Kacey Y
authors.initials: KY
authors.lastname: Eichelberger
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Domain for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway; Department of Pediatrics, Haukeland University Hospital, Bergen, Norway;
authors.forename: Dag
authors.initials: D
authors.lastname: Moster
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;
authors.forename: Rolv Terje
authors.initials: RT
authors.lastname: Lie
authors.affiliation: Domain for Infection Control and Environmental Health and.
authors.forename: Anne Lise
authors.initials: AL
authors.lastname: Brantsæter
authors.affiliation: Domain for Infection Control and Environmental Health and.
authors.forename: Helle Margrete
authors.initials: HM
authors.lastname: Meltzer
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Director General, Norwegian Institute of Public Health, Oslo, Norway; and.
authors.forename: Camilla
authors.initials: C
authors.lastname: Stoltenberg
authors.affiliation: National Institute of Environmental Health Sciences, Durham, NC.
authors.forename: Allen J
authors.initials: AJ
authors.lastname: Wilcox
mesh_terms: D000328:Adult; D002110:Caffeine / Q000008:administration & dosage* / Q000009:adverse effects; D002253:Carbonated Beverages / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000254:growth & development; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D009035:Mothers; D009664:Norway / Q000453:epidemiology; D011181:Postnatal Care; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D002110:Caffeine
keywords: Cerebral palsy; antenatal caffeine exposure; caffeinated soft drinks; caffeine consumption; pregnancy; prospective cohort study