产前咖啡因评估：胎儿和母体生物标志物还是自我报告的摄入量？
Prenatal caffeine assessment: fetal and maternal biomarkers or self-reported intake?
作者信息
Grosso Laura M, Triche Elizabeth, Benowitz Neal L, Bracken Michael B
机构信息
Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University School of Medicine, Department of Epidemiology and Public Health, One Church Street, New Haven, CT 06510, USA.
出版信息
Ann Epidemiol. 2008 Mar;18(3):172-8. doi: 10.1016/j.annepidem.2007.11.005.
PURPOSE
We sought to examine associations among measures of caffeine exposure, including maternal urine, umbilical cord blood, and maternal self report.
METHODS
Pregnant women were recruited from 56 obstetric practices and 15 clinics associated with six hospitals in Connecticut and Massachusetts between September 1996 and January 2000; 3633 women were enrolled. Maternal urine throughout pregnancy and umbilical cord blood samples were analyzed for caffeine, paraxanthine, theophylline, and theobromine. Maternal caffeine intake was assessed throughout pregnancy.
RESULTS
Urinary and cord blood biomarkers were correlated with reported intake throughout pregnancy (range r = 0.35-0.66; p < 0.0001). Infants of smokers had greater cord blood concentrations of paraxanthine, reflecting faster caffeine metabolism in smokers, and cord blood paraxanthine levels were more strongly correlated with intake in smokers.
CONCLUSION
Maternal self reported intake may still be the optimal and most valid measure of antenatal caffeine exposure, since biomarkers do not reflect exposure over pregnancy.
目的
我们试图研究咖啡因暴露量的各项指标之间的关联，这些指标包括孕妇尿液、脐带血以及孕妇自我报告。
方法
1996年9月至2000年1月期间，从康涅狄格州和马萨诸塞州六家医院所属的56个产科诊所和15个门诊部招募孕妇；共有3633名妇女入组。对整个孕期的孕妇尿液和脐带血样本进行咖啡因、副黄嘌呤、茶碱和可可碱分析。在整个孕期评估孕妇的咖啡因摄入量。
结果
尿液和脐带血生物标志物与整个孕期报告的摄入量相关（范围r = 0.35 - 0.66；p < 0.0001）。吸烟者的婴儿脐带血中副黄嘌呤浓度更高，这反映出吸烟者咖啡因代谢更快，并且脐带血中副黄嘌呤水平与吸烟者的摄入量相关性更强。
结论
孕妇自我报告的摄入量可能仍是产前咖啡因暴露的最佳且最有效的指标，因为生物标志物无法反映整个孕期的暴露情况。
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