Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
J Child Psychol Psychiatry. 2022 May;63(5):563-578. doi: 10.1111/jcpp.13495. Epub 2021 Jul 27.
Despite the widespread use of caffeine including consumption during pregnancy, the effect of prenatal caffeine exposure on child brain development and behavior is unclear.
To address this, we used data from the Adolescent Brain and Cognitive Development Study (n = 11,875 children aged 9-11 years from 22 sites across the United States). We explored the associations between prenatal caffeine exposure and various developmental outcomes including birth outcomes, physical health, behavior problems, cognition, substance use and brain structure in children, and evaluated dose effects.
Among 9,978 children (4,745 females) who had valid data for prenatal caffeine exposure and whose mothers did not use drugs of abuse after knowing of pregnancy, 4,170 (41.79%) had no prenatal caffeine exposure, 2,292 (22.97%) had daily, 1,933 (19.37%) had weekly, and 1,583 (15.86%) had less than weekly exposures. Prenatal caffeine exposure including the widely recommended 'safe' dose was associated with greater externalizing problems, whereas greater BMI and soda consumption were only observed in children with high dose exposures (3+ per day). Notably, the effect size for association of externalizing problems with prenatal caffeine exposure was comparable with that reported for prenatal alcohol (The American Journal of Psychiatry, 177, 2020 and 1060) and prenatal cannabis (JAMA Psychiatry, 78, 2020 and 64) exposures from previous ABCD publications. Additionally, prenatal caffeine exposure was associated with brain structural changes that included greater posterior and lower frontal cortical thickness and altered parietooccipital sulcal depth.
The recommended 'safe' dose of caffeine during pregnancy should be carefully studied to assess whether the behavioral and brain correlates observed here are clinically relevant and determine whether it needs adjustment. Because of the high prevalence of caffeine use in the general population, studies on prenatal exposure to drugs of abuse should include prenatal caffeine use as a covariate.
尽管咖啡因的使用广泛，包括在怀孕期间摄入，但产前咖啡因暴露对儿童大脑发育和行为的影响尚不清楚。
为了解决这个问题，我们使用了来自美国 22 个地点的 11875 名 9-11 岁青少年大脑与认知发育研究（ABCD 研究）的数据。我们探讨了产前咖啡因暴露与各种发育结果之间的关联，包括出生结果、身体健康、行为问题、认知、物质使用和儿童大脑结构，并评估了剂量效应。
在 9978 名儿童（4745 名女性）中，有有效的产前咖啡因暴露数据，且其母亲在得知怀孕后没有使用滥用药物，其中 4170 名（41.79%）没有产前咖啡因暴露，2292 名（22.97%）每天摄入，1933 名（19.37%）每周摄入，1583 名（15.86%）每周摄入不到一次。产前咖啡因暴露，包括广泛推荐的“安全”剂量，与更多的外化问题相关，而只有高剂量暴露的儿童才会出现更大的 BMI 和苏打水消费（每天 3 次以上）。值得注意的是，与产前咖啡因暴露相关的外化问题的关联效应大小与之前 ABCD 研究中报告的产前酒精（美国精神病学杂志，177，2020 年和 1060）和产前大麻（JAMA 精神病学，78，2020 年和 64）暴露的报告相当。此外，产前咖啡因暴露与大脑结构变化有关，包括更大的后皮质和更低的额皮质厚度以及改变的顶枕沟深度。
怀孕期间推荐的“安全”咖啡因剂量应仔细研究，以评估这里观察到的行为和大脑相关性是否具有临床相关性，并确定是否需要调整。由于咖啡因在普通人群中的高使用率，对滥用药物的产前暴露研究应将产前咖啡因使用作为协变量。
