BMJ 2003;326:420 ( 22 February )

Papers

Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study

Kirsten Wisborg, specialist registrar, ^a Ulrik Kesmodel, specialist registrar, ^d Bodil Hammer Bech, senior house officer, ^e Morten Hedegaard, associate professor, ^b Tine Brink Henriksen, associate professor. ^c

^a Perinatal Epidemiological Research Unit, Department of Obstetrics and Gynaecology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark, ^b Department of Obstetrics and Gynaecology, Aarhus University Hospital, ^c Department of Paediatrics, Aarhus University Hospital, ^d Department of Epidemiology and Social Medicine, University of Aarhus, DK-8000 Aarhus C, Denmark, ^e Danish Epidemiology Science Centre, University of Aarhus

Correspondence to: K Wisborg kiwi{at}perinatal.dk

Objective: To study the association between coffee consumption during pregnancy and the risk of stillbirth and infant death in the first year of life.
Design: Prospective follow up study.
Setting: Aarhus University Hospital, Denmark, 1989-96.
Participants: 18 478 singleton pregnancies in women with valid information about coffee consumption during pregnancy.
Main outcome measures: Stillbirth (delivery of a dead fetus at 28 weeks' gestation) and infant death (death of a liveborn infant during the first year of life).
Results: Pregnant women who drank eight or more cups of coffee per day during pregnancy had an increased risk of stillbirth compared with women who did not drink coffee (odds ratio=3.0, 95% confidence interval 1.5 to 5.9). After adjustment for smoking habits and alcohol intake during pregnancy, the relative risk of stillbirth decreased slightly. Adjustment for parity, maternal age, marital status, years of education, occupational status, and body mass index did not substantially change the estimates of association. There was no significant association between coffee consumption and death in the first year of life after adjustment for smoking habits during pregnancy.
Conclusion: Drinking coffee during pregnancy is associated with an increased risk of stillbirth but not with infant death.

What is already known on this topic Results from studies in monkeys suggest that high daily doses of caffeine in pregnancy increase the risk of stillbirth, but evidence from studies in humans has been lacking What this study adds Pregnant women who drank eight or more cups of coffee a day had more than twice the risk of stillbirth compared with women who did not drink coffee during pregnancy

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