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孕期咖啡因暴露、小于胎龄儿出生与新生儿结局——来自挪威母亲和儿童队列研究的结果。

Caffeine exposure during pregnancy, small for gestational age birth and neonatal outcome - results from the Norwegian Mother and Child Cohort Study.

机构信息

Institute of Clinical Sciences, Department of Obstetrics and Gynecology, University of Gothenburg, Sahlgrenska Academy, SE-416 85, Gothenburg, Sweden.

Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.

出版信息

BMC Pregnancy Childbirth. 2019 Feb 26;19(1):80. doi: 10.1186/s12884-019-2215-9.

Abstract

BACKGROUND

Maternal caffeine intake has repeatedly been linked to babies being born small for gestational age (SGA). SGA babies are known to be at increased risk for adverse neonatal outcomes. The aim of this study was to explore the associations between prenatal caffeine exposure and neonatal health.

METHODS

The study is based on 67,569 full-term singleton mother-infant pairs from the Norwegian Mother and Child Cohort Study. Caffeine consumption from different sources was self-reported in gestational week 22. Neonatal compound outcomes, namely (1) morbidity/mortality and (2) neonatal intervention, were created based on the Medical Birth Registry of Norway. Adjusted logistic regression was performed.

RESULTS

Caffeine exposure was associated to SGA (OR = 1.16, 95%CI: 1.10; 1.23) and being born SGA was significantly associated with neonatal health (OR = 3.09, 95%CI: 2.54; 3.78 for morbidity/mortality; OR = 3.94, 95%CI: 3.50; 4.45 for intervention). However, prenatal caffeine exposure was neither associated with neonatal morbidity/mortality (OR = 1.01, 95%CI: 0.96; 1.07) nor neonatal intervention (OR = 1.02, 95%CI: 1.00; 1.05 for a 100 mg caffeine intake increase). Results did not change after additional adjustment for SGA status.

CONCLUSIONS

Moderate prenatal caffeine exposure (< 200 mg/day) does not seem to impair neonatal health, although prenatal caffeine exposure is associated with the child being born SGA and SGA with neonatal health. We suggest diversity in neonatal outcomes of SGA infants according to the underlying cause of low birth weight.

摘要

背景

母体咖啡因摄入与婴儿出生时的胎龄大小有关(SGA)。已知 SGA 婴儿发生不良新生儿结局的风险增加。本研究旨在探讨产前咖啡因暴露与新生儿健康之间的关系。

方法

本研究基于挪威母亲和儿童队列研究中的 67569 名足月单胎母婴对。在妊娠第 22 周时自我报告咖啡因的不同来源的摄入量。根据挪威医学出生登记处,创建了新生儿复合结局,即(1)发病率/死亡率和(2)新生儿干预。进行了调整后的逻辑回归分析。

结果

咖啡因暴露与 SGA 相关(OR=1.16,95%CI:1.10;1.23),SGA 出生与新生儿健康显著相关(OR=3.09,95%CI:2.54;3.78 用于发病率/死亡率;OR=3.94,95%CI:3.50;4.45 用于干预)。然而,产前咖啡因暴露与新生儿发病率/死亡率无关(OR=1.01,95%CI:0.96;1.07),也与新生儿干预无关(OR=1.02,95%CI:1.00;1.05 对于增加 100mg 咖啡因摄入量)。在对 SGA 状态进行额外调整后,结果没有变化。

结论

适度的产前咖啡因暴露(<200mg/天)似乎不会损害新生儿的健康,尽管产前咖啡因暴露与儿童出生时的 SGA 以及 SGA 与新生儿健康有关。我们建议根据低出生体重的潜在原因,对 SGA 婴儿的新生儿结局进行多样化处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e06a/6390347/3c7f6f62f7e8/12884_2019_2215_Fig1_HTML.jpg

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