HIGH LEVEL OF CAFFEINE, RISK OF MISCARRIAGE ?

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Kaiser study links high levels of caffeine, risk of miscarriage !

By Barbara Feder OstrovMercury News
Article Launched: 01/21/2008 01:30:38 AM PST

Adding to the eternal debate about what pregnant women may safely eat and drink, a new Kaiser Permanente study suggests high doses of caffeine may double the rate of miscarriage.
Doctors generally urge pregnant women to limit their caffeine consumption to no more than one or two small cups of coffee daily.

Research on the overall effects of caffeine on miscarriage or premature birth remain inconclusive, although studies have shown that high levels of caffeine appear to be harmful, a finding echoed in the Kaiser study.

For the study, published in the February issue of the American Journal of Obstetrics and Gynecology, Kaiser researchers evaluated a group of 1,063 women early in their pregnancies.
The women provided a detailed account of their caffeine consumption and how they may have changed their habits after learning they were pregnant. The women also were asked about other factors that affect miscarriage risk, such as smoking, alcohol consumption and nausea.

Of the 1,063 women in the study, 172 miscarried. About 12 percent of the women who did not use caffeine at all miscarried, compared with about 25 percent of the women who drank more than 200 milligrams of caffeine daily. (There was no statistically significant difference between the women who drank from zero to 200 milligrams of caffeine daily and those who consumed nothing.)

The researchers focused on women who never changed their caffeine habits after learning they were




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pregnant. Previous studies have been criticized for failing to account for the fact that women with nausea tend to avoid coffee, while women without nausea - itself a risk factor - do not. Caffeine's apparently harmful effects persisted even after the researchers adjusted for age, smoking and other factors.

The 200-milligram figure is significant because many women do not know just how high the caffeine content in their drinks can be. While a 12-ounce can of diet Coke may contain only 47 milligrams, a 16-ounce "grande" cup of Starbucks coffee contains up to 330 milligrams.
Melissa Stanis, whose first baby is due in July, said she dramatically cut back her diet Coke habit from up to eight cans a day to one, at her doctor's behest. Studies such as Kaiser's help reinforce her decision, but it's still difficult, she said.

"I covet my one soda a day," said Stanis, a 32-year-old music editor who recently moved to Saratoga from Southern California. "I make a deliberate decision of when to have it, and I always want more."

David Savitz, a Mount Sinai School of Medicine researcher who has studied the link between caffeine and miscarriage, called the Kaiser study "very well done" but cautioned that only 39 percent of eligible women participated, a potential limitation.

Women should be aware that the evidence about caffeine's impact on miscarriage is mixed, Savitz said. "But if there's a risk, four cups is worse than three, and three is worse than two. Nobody is suggesting that one to two small cups of coffee a day is harmful."

Dr. Ruth Lathi, a Stanford University reproductive endocrinologist specializing in recurrent miscarriage, stressed that caffeine's effects are difficult to study.

"It's very hard to prove cause and effect during pregnancy. There are so many different factors that can contribute to miscarriage or pre-term delivery," Lathi said. "There is a lot of room for opinion in giving advice to women who are pregnant."




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Contact Barbara Feder Ostrov at bfeder@mercurynews.com or (408) 920-5064