Caffeine During Pregnancy: A Systematic Review of the Risks for Miscarriage and Stillbirths

Background: Maternal caffeine consumption during pregnancy directly affects the developing fetus as caffeine is rapidly absorbed in the maternal gastrointestinal tract and freely passes across the placenta. There is much concern about the affect of caffeine on reproductive outcomes prior to pregnancy and increased rates of fetal death. Since the 1980s, numerous studies have been published on caffeine intake during pregnancy and the risk of miscarriage and stillbirths. However, a clear consensus on whether caffeine posses these risks has yet to be determined. A systematic review of the literature using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool developed by the GRADE Working Group will be conducted to determine an accepted conclusion to this topic. Method: An exhaustive search of available medical literature was conducted using the following databases; Medline, PubMed, Cochrane Systematic Reviews, and CINAHL. Results: A total of five studies, four cohort and one case-control, were reviewed in their entirety. These studies looked at the relationship between caffeine intake during pregnancy and its proposed associations to an increase risk of miscarriage and stillbirth rates. Conclusion: Based on the combined results there is still much uncertainty. Four studies, all demonstrate a dose-response related effect on caffeine and negative pregnancy outcomes. Only one study did not show a relationship between caffeine and miscarriages or stillbirths. The final GRADE for this review is moderate. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/269 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/269 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed. Caffeine During Pregnancy A course paper presented to the College of Health Professions in partial fulfillment of the requirements of the degree of Pacific University School of Physician Assistant Studies Clinical Graduate Project Instructors: Torry Cobb, DHSc, MPH, PA : A Systematic Review of the Risks for Miscarriage and Stillbirths