Grodstein F, Goldman M B, Ryan L, Cramer D W
Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Am J Epidemiol. 1993 Jun 15;137(12):1353-60. doi: 10.1093/oxfordjournals.aje.a116644.
Several studies have reported an association between caffeine intake and delay to conception. To study this relation further, the authors examined caffeine use in 1,050 women with primary infertility and 3,833 women who had recently given birth during the period 1981-1983 in the United States and Canada. The cases were separated by the cause of their infertility: ovulatory factor, tubal disease, cervical factor, endometriosis, or idiopathic infertility. The relative risks of each type of infertility associated with caffeine were calculated using separate logistic regression models and controlling for relevant confounding factors, such as age, center, cigarette smoking, lifetime number of sexual partners, alcohol consumption, contraception, body mass index, and exercise. A significant increase in the risk of infertility due to tubal disease or endometriosis was observed for the upper levels of caffeine intake, indicating a threshold effect. For tubal infertility, a relative risk of 1.5 (95% confidence interval (CI) 1.1-2.0) was found in women who consumed more than 7 g of caffeine per month as compared with those who consumed 3 g or less per month. For endometriosis, the relative risk was 1.9 (95% CI 1.2-2.9) in women who consumed 5.1-7 g/month and 1.6 (95% CI 1.1-2.4) in those with an intake of more than 7 g/month. These data suggest that caffeine deserves further study with regard to its effects on the female reproductive system.
多项研究报告了咖啡因摄入量与受孕延迟之间的关联。为了进一步研究这种关系,作者在美国和加拿大调查了1981年至1983年期间1050名原发性不孕妇女和3833名近期分娩妇女的咖啡因使用情况。这些病例按不孕原因分类:排卵因素、输卵管疾病、宫颈因素、子宫内膜异位症或不明原因不孕。使用单独的逻辑回归模型并控制相关混杂因素,如年龄、研究中心、吸烟、性伴侣终身数量、饮酒、避孕措施、体重指数和运动情况,计算了与咖啡因相关的每种不孕类型的相对风险。观察到咖啡因摄入量较高时,因输卵管疾病或子宫内膜异位症导致不孕的风险显著增加,表明存在阈值效应。对于输卵管性不孕,每月摄入超过7克咖啡因的女性与每月摄入3克或更少咖啡因的女性相比,相对风险为1.5(95%置信区间(CI)1.1 - 2.0)。对于子宫内膜异位症,每月摄入5.1 - 7克咖啡因的女性相对风险为1.9(95%CI 1.2 - 2.9),每月摄入量超过7克的女性相对风险为1.6(95%CI 1.1 - 2.4)。这些数据表明,咖啡因对女性生殖系统的影响值得进一步研究。