Maternal caffeine intake during pregnancy is associated with risk of low birth weight: a systematic review and dose-response meta-analysis
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BACKGROUND: Considerable controversy exists regarding the relation between maternal caffeine intake during pregnancy and risk of low birth weight (birth weight <2,500 g). We aim to assess this association using a systematic review and dose-response meta-analysis of prospective studies. METHODS: Potential articles were identified by searching MEDLINE and SCOPUS databases through 17 July 2013. Two authors independently extracted information on study design, participant characteristics and estimates of associations. Random-effects models were used to derive the summary relative risks (RRs) and corresponding 95% confidence intervals (CIs). Dose-response relationships were assessed using generalized least-squares trend estimation. RESULTS: In our meta-analysis, we included 13 prospective studies: 9 with low birth weight as a binary outcome variable (90,747 participants and 6,303 cases) and 6 with birth weight as a continuous outcome variable (10,015 participants; 2 studies reported both types of outcomes). Compared with the reference category with no or very low caffeine intake, the RR (95% CI) of low birth weight was 1.13 (1.06 to 1.21; I 2 0.0%) for low intake (50 to 149 mg/day), 1.38 (1.18 to 1.62; I 2 31.9%) for moderate intake (150 to 349 mg/day), and 1.60 (1.24 to 2.08; I 2 65.8%) for high intake (≥350 mg/day). In the dose-response analysis, each 100-mg/day increment in maternal caffeine intake (around one cup of coffee) was associated with 13% (RR 1.13, 1.06 to 1.21) higher risk of low birth weight. The association persisted in strata defined according to various study characteristics. Moderate (-33 g, 95% CI -63 to -4; I 2 0.3%) and high (-69 g, 95% CI -102 to -35; I 2 0.0%) caffeine intakes were also associated with a significantly lower birth weight as compared with the reference category. CONCLUSIONS: Higher maternal caffeine intake during pregnancy was associated with a higher risk of delivering low birth weight infants. These findings support recommendations to restrict caffeine intake during pregnancy to low levels.
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Both meta-analyses found an increased risk of low-birth weight offspring for every 100 mg/day increase in maternal caffeine consumption (OR, 1.03-1.62).
“Furthermore, both meta-analyses found an increased risk of low-birth weight offspring for every 100 mg/day increase in maternal caffeine consumption (OR, 1.03–1.62).”
From The Safety of Ingested Caffeine: A Comprehensive Review (2017) · cites this paper as [146]
Two separate meta-analyses reported odds ratios of having a newborn classified as low-birth weight for maternal caffeine consumption above 50 mg/day when compared to intakes below 50 mg/day.
“Two separate meta-analyses of different sets of studies by Rhee et al. (142) and Chen et al. (146) reported odds ratios of having a newborn classified as low-birth weight (less than 2,500 g) for maternal caffeine consumption above 50 mg/day when compared to intakes below 50 mg/day.”
From The Safety of Ingested Caffeine: A Comprehensive Review (2017) · cites this paper as [146]
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- Authors
- Chen, L.-W., Wu, Y., Neelakantan, N., Chong, M. F.-F., Pan, A., & van Dam, R. M.
- Affiliations
- National University of Singapore (SG)
- Agency for Science, Technology and Research (SG)
- Venue
- BMC Medicine
- Published
- 2014-09-19
- Volume
- 12
- Issue
- 1
- Pages
- 174-174
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC4198801
- OpenAlex
- W2058812183
- Cited by
- 147
- References
- 67
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 14 · 2023: 13 · 2022: 15 · 2021: 15 · 2020: 13 · 2019: 13 · 2018: 13 · 2017: 15 · 2016: 11 · 2015: 13 · 2014: 2
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- National University of Singapore (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- maternal caffeine intake, pregnancy, low birth weight, dose-response relationship, caffeine consumption, birth weight
- MeSH terms
- Birth Weight, Caffeine, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Male, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Risk
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