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孕期母亲咖啡因摄入量与低出生体重、儿童期超重和肥胖的关联:队列研究的荟萃分析

Association of maternal caffeine intake during pregnancy with low birth weight, childhood overweight, and obesity: a meta-analysis of cohort studies.

作者信息

Jin Feng, Qiao Chong

机构信息

Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Int J Obes (Lond). 2021 Feb;45(2):279-287. doi: 10.1038/s41366-020-0617-4. Epub 2020 Jun 9.

Abstract

BACKGROUND

Epidemiological studies reported inconsistent results on the associations between maternal caffeine intake during pregnancy and risk of low birth weight (LBW) and childhood overweight and obesity in their offspring.

METHODS

We conducted a meta-analysis of cohort studies to quantitatively assess these associations. Pertinent studies were identified by searching PubMed and Embase through June 2019. Study-specifics risk estimates were combined using fixed effects models, or random-effects models when significant heterogeneity was detected. Dose-response analysis was modeled by using restricted cubic splines.

RESULTS

A total of 15 cohort studies, with 102,347 pregnancy women, was included in the meta-analysis. The pooled relative risk (RR) for LBW was 1.33 (95% CI: 1.12, 1.57) for mothers with the highest compared with the lowest level of caffeine intake during pregnancy, with significant heterogeneity across studies (I = 49.3%, P = 0.032). The pooled RR was 1.07 (95% CI: 1.02, 1.11) for each 100 mg/day increase of caffeine intake. The pooled RR for childhood overweight and obesity was 1.39 (95% CI: 1.15, 1.69) for mothers with the highest compared with the lowest level of caffeine intake during pregnancy. No significant heterogeneity across studies was detected (I = 38.9%, P = 0.179). The pooled RR was 1.31 (95% CI: 1.11, 1.55) for each 100 mg/day increase of caffeine intake. No evidence of publication bias was indicated.

CONCLUSIONS

Maternal caffeine intake during pregnancy is associated with higher risk of LBW and childhood overweight and obesity. Further studies may focus on investigating the potential mechanisms before the recommendation of complete avoidance of caffeine intake during pregnancy.

摘要

背景

流行病学研究报告了孕期母亲咖啡因摄入量与低出生体重(LBW)风险以及其后代儿童期超重和肥胖之间关联的不一致结果。

方法

我们进行了一项队列研究的荟萃分析,以定量评估这些关联。通过检索截至2019年6月的PubMed和Embase来确定相关研究。使用固定效应模型合并特定研究的风险估计值,当检测到显著异质性时则使用随机效应模型。剂量反应分析采用受限立方样条进行建模。

结果

荟萃分析共纳入15项队列研究,涉及102347名孕妇。孕期咖啡因摄入量最高与最低的母亲相比,低出生体重的合并相对风险(RR)为1.33(95%CI:1.12,1.57),各研究间存在显著异质性(I = 49.3%,P = 0.032)。咖啡因摄入量每增加100毫克/天,合并RR为1.07(95%CI:1.02,1.11)。孕期咖啡因摄入量最高与最低的母亲相比,儿童期超重和肥胖的合并RR为1.39(95%CI:1.15,1.69)。未检测到各研究间存在显著异质性(I = 38.9%,P = 0.179)。咖啡因摄入量每增加100毫克/天,合并RR为1.31(95%CI:1.11,1.55)。未表明存在发表偏倚的证据。

结论

孕期母亲咖啡因摄入量与低出生体重以及儿童期超重和肥胖的较高风险相关。在建议孕期完全避免咖啡因摄入之前,进一步的研究可侧重于探究潜在机制。

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