Heavy caffeine intake may mean smaller babies

Reported May 20, 2010

(Reuters Health) - Pregnant women who down six coffee cups' worth of caffeine every day may have smaller babies than those who consume less caffeine, a new study finds.

Researchers found that among more than 7,300 Dutch women followed from early pregnancy onward, between 2 and 3 percent said they consumed the caffeine equivalent of six cups of coffee per day during any trimester. On average, their babies' length at birth was slightly shorter than that of newborns whose mothers had consumed less caffeine during pregnancy.

Heavy caffeine consumers also had an increased risk of having a baby who was small for gestational age -- smaller than the norm for the baby's sex and the week of pregnancy during which he or she was born.

That finding, however, was based on a small number of babies, and the significance is uncertain. Of 104 infants born to women with the highest caffeine intakes, seven were small for gestational age.

The findings, reported in the American Journal of Clinical Nutrition, add to the conflicting body of research into whether caffeine during pregnancy affects fetal growth.

Some studies, for instance, have linked regular caffeine consumption during pregnancy -- even a relatively modest one or two cups of coffee a day -- to an increased risk of low birth weight. But other studies have found no such effects. Researchers have also come to conflicting conclusions as to whether caffeine affects the risk of miscarriage.

In this latest study, Rachel Bakker and colleagues at Erasmus Medical Center in Rotterdam used ultrasound scans to monitor fetal growth over the course of pregnancy in 7,346 women.

At each trimester, the women reported on their usual intake of coffee and tea. Most women consumed less than the equivalent of four cups of coffee per day at any point in pregnancy, but between 2 and 3 percent downed six or more cups' worth of caffeine.

Overall, babies born to heavy caffeine consumers were slightly shorter, on average, at birth and during all three trimesters of fetal development, based on the ultrasound tests.

"Caffeine intake seems to affect length growth of the fetus from the first trimester onwards," Bakker told Reuters Health in an email.

The implication, she said, is that pregnant women should not consume more than six cups of coffee per day. However, the findings also do not mean that less coffee is generally "safe" during pregnancy.

"We only studied the effect of caffeine on fetal growth," Bakker said. "Future studies on possible other effects of maternal caffeine intake are therefore needed."

Given the uncertainty about whether and how caffeine might affect pregnancy and fetal development, experts generally recommend that to be safe, pregnant women limit their intake.

The March of Dimes, for example, suggests that, based on research into miscarriage risk, pregnant women get no more than 200 milligrams of caffeine per day -- roughly the amount in 12 ounces of coffee.