Savitz David A, Chan Ronna L, Herring Amy H, Howards Penelope P, Hartmann Katherine E
Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.
Epidemiology. 2008 Jan;19(1):55-62. doi: 10.1097/EDE.0b013e31815c09b9.
Coffee and caffeine have been inconsistently found to be associated with increased risk of clinical miscarriage-a potentially important association given the high prevalence of exposure.
Women were recruited before or early in pregnancy and interviewed regarding sources of caffeine, including assessment of changes over the perinatal period. We identified 2407 clinically-recognized pregnancies resulting in 258 pregnancy losses. We examined the relationship of coffee and caffeine intake with clinically-recognized pregnancy loss prior to 20 weeks' completed gestation, using a discrete-time continuation ratio logistic survival model.
Coffee and caffeine consumption at all 3 time points were unrelated to total miscarriage risk and the risk of loss after the interview. Reported exposure at the time of the interview was associated with increased risk among those with losses before the interview.
There is little indication of possible harmful effects of caffeine on miscarriage risk within the range of coffee and caffeine consumption reported, with a suggested reporting bias among women with losses before the interview. The results may reflect exposure misclassification and unmeasured heterogeneity of pregnancy losses.
咖啡和咖啡因与临床流产风险增加之间的关联并不一致——鉴于暴露的高发生率,这是一个潜在的重要关联。
在怀孕前或怀孕早期招募女性,并就咖啡因来源进行访谈,包括评估围产期的变化。我们确定了2407例临床确诊的妊娠,其中有258例妊娠丢失。我们使用离散时间连续比例逻辑生存模型,研究了咖啡和咖啡因摄入量与妊娠20周前临床确诊的妊娠丢失之间的关系。
在所有三个时间点,咖啡和咖啡因的摄入量与总流产风险以及访谈后的丢失风险均无关。访谈时报告的暴露与访谈前有丢失情况的女性的风险增加有关。
在所报告的咖啡和咖啡因消费范围内,几乎没有迹象表明咖啡因对流产风险有潜在有害影响,访谈前有妊娠丢失的女性可能存在报告偏倚。结果可能反映了暴露分类错误和妊娠丢失的未测量异质性。