Re: Pregnancy Problems Tied to Caffeine
From: art fougner, md (evsono@pipeline.com)
Mon Jan 21 11:28:08 2008
Curiously, in this month's Epidemiology -
Epidemiology. 2008 Jan;19(1):55-62 - comes this article with a
different conclusion.
Caffeine and Miscarriage Risk.
Savitz DA, Chan RL, Herring AH, Howards PP, Hartmann KE.
>From the *Department of Community and Preventive Medicine, Mount Sinai
School of Medicine, New York, New York; Departments of †Epidemiology and
‡Biostatistics, University of North Carolina School of Public Health,
Chapel Hill, North Carolina; §Division of Epidemiology, Statistics and
Prevention Research, National Institute of Child Health and Human
Development, Bethesda, Maryland; and ¶Department of Obstetrics and
Gynecology, Vanderbilt University School of Medicine, Nashville,
Tennessee.
BACKGROUND:: Coffee and caffeine have been inconsistently found to be
associated with increased risk of clinical miscarriage-a potentially
important association given the high prevalence of exposure. METHODS::
Women were recruited before or early in pregnancy and interviewed
regarding sources of caffeine, including assessment of changes over the
perinatal period. We identified 2407 clinically-recognized pregnancies
resulting in 258 pregnancy losses. We examined the relationship of
coffee and caffeine intake with clinically-recognized pregnancy loss
prior to 20 weeks' completed gestation, using a discrete-time
continuation ratio logistic survival model. RESULTS:: Coffee and
caffeine consumption at all 3 time points were unrelated to total
miscarriage risk and the risk of loss after the interview. Reported
exposure at the time of the interview was associated with increased risk
among those with losses before the interview. CONCLUSIONS:: There is
little indication of possible harmful effects of caffeine on miscarriage
risk within the range of coffee and caffeine consumption reported, with
a suggested reporting bias among women with losses before the interview.
The results may reflect exposure misclassification and unmeasured
heterogeneity of pregnancy losses.
I guess this article violated the MSM's - "If it bleeds, it leads" modus
operandi.
Medicine swings like a pendulum do.
Art
At Mon, 21 Jan 2008, art fougner, md wrote:
>
>Dean
>
>Supposedly in next month's Grey Journal. One of my pet peeves is the
>release of articles sure to generate media buzz to the press prior to
>their release to the physicians who will have to field the phone calls.
>
>Art
>
>At Mon, 21 Jan 2008, Dean Huffman . wrote:
>>
>>.
>>
>>[NOTE: I have not yet been able to find the original journal article.]
>>
>>Pregnancy Problems Tied to Caffeine
>>
>>By DENISE GRADY
>>
>>Published: January 21, 2008
>>
>>Too much caffeine during pregnancy may increase the risk of miscarriage, a new
>>study says, and the authors suggest that pregnant women may want to reduce
>>their intake or cut it out entirely.
>>
>>Many obstetricians already advise women to limit caffeine, though the subject
>>has long been contentious, with conflicting studies, fuzzy data and various
>>recommendations given over the years.
>>
>>The new study, being published Monday in the Journal of Obstetrics and
>>Gynecology, finds that pregnant women who consume 200 milligrams or more of
>>caffeine a day — the amount in 10 ounces of coffee or 25 ounces of tea — may
>>double their risk of miscarriage.
>>
>>Pregnant women should try to give up caffeine for at least the first three or
>>four months, said the lead author of the study, Dr. De-Kun Li, a reproductive
>>and perinatal epidemiologist at the Kaiser Permanente Division of Research in
>>Oakland, Calif.
>>
>>“If, for whatever reason, they really can’t do it, think of cutting to one cup
>>or switching to decaf,” Dr. Li said. “Stopping caffeine really doesn’t have any
>>downside.”
>>
>>Professional groups like the American College of Obstetricians and Gynecologists
>>and the American Society for Reproductive Medicine have not taken official
>>positions on caffeine, representatives said.
>>
>>On Friday, the March of Dimes Web site said most experts agreed that the amount
>>of caffeine found in 8 to 16 ounces of coffee a day was safe. It noted that
>>some studies had linked higher amounts to miscarriage and low birth weight, but
>>stated: “However, there is no solid proof that caffeine causes these problems.
>>Until more is known, women should limit their caffeine intake during
>>pregnancy.”
>>
>>Now, having reviewed the new study, the March of Dimes plans to change its
>>message, to advise women who are pregnant or trying to conceive to limit their
>>daily caffeine intake to 200 milligrams or less, said Janis Biermann, its
>>senior vice president of education and health promotion.
>>
>>“Women do need good guidance,” she said.
>>
>>Dr. Li’s study included 1,063 pregnant women who were interviewed once about
>>their caffeine intake. At the time of the interview, their median length of
>>pregnancy was 71 days. But 102 had already miscarried — not surprising, because
>>most miscarriages occur very early in pregnancy. Later, 70 more women
>>miscarried, for a miscarriage rate of 16 percent for the group — a typical
>>rate.
>>
>>Of 264 women who said they had used no caffeine, 12.5 percent had miscarriages.
>>But the miscarriage rate was 24.5 percent in the 164 women who consumed 200
>>milligrams or more per day. The increased risk was associated with caffeine
>>itself and not with other known risk factors like the mother’s age or smoking
>>habits, the researchers said.
>>
>>Dr. Li said the study answered an important question that previous research had
>>left unresolved. Women who have morning sickness are less likely to miscarry
>>than those who do not, possibly because the same hormonal changes that cause
>>nausea and vomiting contribute to a healthy pregnancy. But some researchers
>>said morning sickness could lead to confusing results in caffeine studies.
>>These researchers argued that because they feel ill, some women may consume
>>less caffeine. That tendency may make it appear that they are less likely to
>>miscarry because they avoid caffeine, when the reason is actually that they
>>began with healthier pregnancies.
>>
>>Dr. Li said he and his colleagues had determined that the risk from caffeine was
>>real and could not be explained away by different rates of morning sickness.
>>
>>Dr. Carolyn Westhoff, a professor of obstetrics and gynecology, and
>>epidemiology, at Columbia University Medical Center, had reservations about the
>>study, noting that miscarriage is difficult to study or explain. Dr. Westhoff
>>said most miscarriages resulted from chromosomal abnormalities, and there was
>>no evidence that caffeine could cause those problems.
>>
>>“Just interviewing women, over half of whom had already had their miscarriage,
>>does not strike me as the best way to get at the real scientific question
>>here,” she said. “But it is an excellent way to scare women.”
>>
>>She said that smoking, chlamidial infections and increasing maternal age were
>>stronger risk factors for miscarriage, and ones that women could do something
>>about.
>>
>>“Moderation in all things is still an excellent rule,” Dr. Westhoff said. “I
>>think we tend to go overboard on saying expose your body to zero anything when
>>pregnant. The human race wouldn’t have succeeded if the early pregnancy was so
>>vulnerable to a little bit of anything. We’re more robust than that.”
>>
>>http://www.nytimes.com/2008/01/21/health/21caffeine.html?ref=health
>
>--
>art fougner, md
>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
