Maternal caffeine consumption and risk of cardiovascular malformations
Maternal caffeine consumption and risk of cardiovascular malformations
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DOI：
10.1002/bdra.20365
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发表时间：
2007-07-01
影响因子：
--
通讯作者：
Correa, Adolfo
中科院分区：
文献类型：
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作者：
Browne, Marilyn L.;Bell, Erin M.;Correa, Adolfo
背景：怀孕期间咖啡因的生理效应和普遍使用要求检查母体咖啡因摄入量和出生缺陷的风险。流行病学研究得出了不同的结果，但这些研究将病因不同的缺陷分组，并没有评估效果的改变。方法：国家出生缺陷预防研究的大样本量和精确的病例分类使我们能够检查咖啡因摄入和特定心血管畸形（CVM）病例组。我们研究了含咖啡因的咖啡、茶、苏打水和巧克力的摄入量，以估计咖啡因的总摄入量，并分别检查了每种含咖啡因饮料的摄入量。评估吸烟、酒精、血管活性药物、叶酸补充剂的使用和婴儿性别对效果的影响。分析了4196例CVM病例婴儿和3957例对照婴儿的母亲访谈报告。结果：我们没有发现母体咖啡因摄入与cvm之间有任何显著的正相关。对于法洛四联症，总的来说，中等（但不高）咖啡因摄入量和不吸烟者的风险没有显著升高（or为1.3至1.5）。吸烟和摄入咖啡因的风险估计值都小于每次接触的额外风险之和。我们观察到咖啡摄入量与房间隔缺损风险呈反比趋势；然而，这种单一的显著关联模式可能是偶然发现的。结论：我们的研究没有发现咖啡因对cvm有明显致畸作用的证据。
Background: The physiologic effects and common use of caffeine during pregnancy call for examination of maternal caffeine consumption and risk of birth defects. Epidemiologic studies have yielded mixed results, but such studies have grouped etiologically different defects and have not evaluated effect modification. Methods: The large sample size and precise case classification of the National Birth Defects Prevention Study allowed us to examine caffeine consumption and specific cardiovascular malformation (CVM) case groups. We studied consumption of caffeinated coffee, tea, soda, and chocolate to estimate total caffeine intake and separately examined exposure to each caffeinated beverage. Smoking, alcohol, vasoactive medications, folic acid supplement use, and infant gender were evaluated for effect modification. Maternal interview reports for 4,196 CVM case infants overall and 3,957 control infants were analyzed. Results: We did not identify any significant positive associations between maternal caffeine consumption and CVMs. For tetralogy of Fallot, nonsignificant elevations in risk were observed for moderate (but not high) caffeine intake overall and among nonsmokers (ORs of 1.3 to 1.5). Risk estimates for both smoking and consuming caffeine were less than the sum of the excess risks for each exposure. We observed an inverse trend between coffee intake and risk of atrial septal defect; however, this single significant pattern of association might have been a chance finding. Conclusions: Our study found no evidence for an appreciable teratogenic effect of caffeine with regard to CVMs.