Should pregnant mothers avoid coffee completely?

During pregnancy, women are encouraged to give up an array of tempting foods and drinks which they might normally enjoy in order to help protect their growing babies. On this list of taboos are foods and drinks that contain caffeine, because it can be detrimental to their baby’s health and development later on in life.

Even at moderate levels, drinking coffee during pregnancy is tied to negative birth outcomes. Now, in a new study, researchers  said that there was “substantial cumulative evidence” of a link between coffee consumption during pregnancy and risk of adverse pregnancy outcomes, including miscarriage, stillbirth, and low birth weight or small for gestational age infants.

The researchers had conducted a database search of negative pregnancy outcomes and common caffeine beverages up to October 2019. They had 1,261 English-language peer-reviewed articles. Additional screening yielded 48 observational studies and meta-analyses about coffee consumption in women, all published in the last two decades. It was in the BMJ Evidence-Based Medicine.

There were 42 findings from 37 observational studies, 10 of which suggested no association between coffee consumption in women and negative pregnancy outcomes. Of 17 findings from 11 meta-analyses, three did not suggest significant relationships.

Two studies reported a 32 per cent and 36 per cent increased risk of miscarriage with higher levels of caffeine consumption (more than 150 mg per day).  Also, three studies found that stillbirth among pregnant women who consumed greater amounts of caffeine was two times, three times or five times compared with women who consumed lower levels, depending on the study.

Also, of the 13 studies that evaluated the caffeine-related risk of low birth weight and small for gestational age infants, only two reported a significant relationship.

Certainly, the amount of caffeine in a cup of coffee will vary depending on the type of coffee and how it’s brewed. The coffee at a restaurant or coffee shop, for example, can range from about 100 mg for a small cup to over 400 mg for a large cup, depending on the brand and the brew.

Also, decaffeinated doesn’t mean caffeine-free. A 16-ounce-cup of brewed decaffeinated coffee typically contains about 12 to 25 mg of caffeine.

Dr Akinlolu Adepoju, a pediatrician at the University College Hospital (UCH), Ibadan, Oyo State stated that consuming too much of caffeine during pregnancy is dangerous, given that it can also affect the unborn baby.

According to him, “Everything taken by mouth, inclusive of caffeine, is broken down in the liver. So if they are harmful, they can injure the liver. This might accelerate the development of liver disease later in the child.”

Even in pregnancy, Dr Adebukola Adesina, consultant obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State, said women are only told to take coffee in moderation because everything a mother does have some form of effect on the unborn baby.

According to Dr Adesina, “if we say that pregnant women should not take coffee because it contains caffeine, then it means that they should not take cola drinks, cocoa products and tea because they also contain caffeine. So, everything should be in moderation that is what we always teach.

“Yes, excessive intake of caffeine can lead to a low birth weight baby. But I am not sure about the liver case, but it may lead to low birth weight. Like every other thing in pregnancy, it should not be excessive; it should be in moderation.”

Due to conflicting conclusions from numerous studies, the March of Dimes states that until more conclusive studies are done, pregnant women should limit caffeine intake to less than 200 mg per day.  This is equal to about two cups of moderate-strength coffee per day.

Also, the World Health Organisation (WHO) currently recommends that pregnant women consume no more than 300mg of caffeine per day – the amount contained in around two cups of medium strength, coffee is to reduce the risk of miscarriage and low birth weight babies.

Even if tallying daily intake of caffeine, been aware of all sources of caffeine that could be consumed is also important. Aside from tea and coffee, other caffeine-containing products are chocolate, cola and other soft drinks, energy drinks, and even some new forms of cereals, biscuits, and chips.

It›s also worth noting that caffeine levels will vary between products and its effects will be different for each individual.

Moreover, energy drinks are not recommended during pregnancy as they may contain high levels of caffeine, and other ingredients not recommended for pregnant women. In fact, labels on energy drinks contain warnings that state: “Not recommended for children, people sensitive to caffeine, pregnant women, or women who are nursing.”

Increased sensitivity to caffeine during pregnancy also occurs because it may take a longer time to clear it from the body than if there is no pregnancy. Caffeine can also reduce the body’s ability to absorb iron, which is a mineral in high demand during pregnancy.

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