Maternal caffeine intake during pregnancy associated with pediatric abdominal, liver fat
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Children born to mothers who consumed at least 360 mg caffeine per day during pregnancy are more likely to have a higher BMI and greater total body, abdominal and liver fat masses compared with children born to mothers who consumed 90 mg or less caffeine per day, according to findings from a population-based study.
“Our study shows that high maternal caffeine intake during pregnancy is related to increased adiposity in the children of these mothers,” Romy Gaillard, MD, PhD, assistant professor in the department of pediatrics, Erasmus MC University Medical Center in Rotterdam, Netherlands, told Healio. “The children of mothers with a high caffeine intake during pregnancy had a higher childhood BMI and more total body fat, abdominal fat and liver fat, as compared to children of mothers who consumed a low amount of caffeine during pregnancy.”
Gaillard and colleagues analyzed data from 4,770 mothers and children participating in Generation R, a prospective, population-based study from early pregnancy onward in Rotterdam. Researchers assessed maternal caffeine intake during pregnancy via questionnaires and childhood fat mass via DXA at age 10 years. To calculate total caffeine intake for each trimester, researchers weighed type of coffee or tea according to caffeine content (caffeinated coffee = 1; caffeinated and decaffeinated coffee = 0.5; decaffeinated coffee = 0; caffeinated tea = 0.5; caffeinated and decaffeinated tea = 0.25; decaffeinated tea = 0; herbal tea = 0; and green tea = 0.5). Each unit of caffeine intake reflected caffeine exposure based on one cup of caffeinated coffee (90 mg caffeine). Total daily caffeine intake was stratified as less than 2 U, 2 U to 3.9 U, 4 U to 5.9 U and at least 6 U per day.
Within the cohort, 58.3% of women consumed less than 2 U caffeine daily, 33.2% consumed between 2 U and 3.9 U, 6.9% consumed between 4 U and 5.9 U and 1.6% consumed at least 6 U caffeine daily.
Researchers found that the children of mothers who consumed between 4 U and 5.9 U caffeine daily had a higher BMI compared with the children of mothers who consumed less than 2 U caffeine per day (mean difference, 0.12 standard deviation [SD]; 95% CI, 0.01-0.24), as well as greater total body fat mass index (mean difference, 0.14 SD; 95% CI, 0.04-0.25) and greater android/gynoid fat mass ratio (mean difference, 0.16 SD; 95% CI, 0.05-0.27). Similarly, compared with the children of mothers who consumed less than 2 U caffeine per day, children of mothers who consumed at least 6 U caffeine per day had a higher BMI (mean difference, 0.24 SD; 95% CI, 0.01-0.47), greater total body fat mass index (mean difference, 0.22 SD; 95% CI, 0.02-0.43) and greater android/gynoid fat mass ratio (mean difference, 0.22 SD; 95% CI, 0.01-0.44).
The children of mothers who consumed at least 6 U caffeine daily were also more likely to have overweight or obesity at age 10 years compared with the children of mothers who consumed 2 U or less per day (OR = 1.59; 95% CI, 0.92-2.75). All results persisted after adjustment for gestational age at birth and birth weight, and associations were similar across pregnancy.
Children of mothers who consumed between 4 U and 5.9 U caffeine daily also had higher liver fat fraction when compared with the reference population (mean difference, 0.2 SD; 95% CI, 0.04-0.36).
“From previous studies, it is already known that mothers who consume a high amount of caffeine during pregnancy have a higher risk of adverse birth outcomes, such as delivering newborns with a low birth weight,” Gaillard said. “Based on these observations, current guidelines already advise pregnant women to limit their caffeine intake to 200 to 300 mg per day during their pregnancy. The findings in our current study support these current guidelines and show that high maternal caffeine intake during pregnancy, above the recommended amount, is not only related to adverse birth outcomes, but also related to increased childhood fat levels in the offspring.” – by Regina Schaffer
For more information:
Romy Gaillard, MD, PhD, can be reached at the Generation R Study Group, Erasmus MC, University Medical Center, P.O. Box 2040, Rotterdam, 3,000 CA, Netherlands; email: r.gaillard@erasmusmc.nl.
Disclosures: The authors report no relevant financial disclosures.
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Eleni Papadopoulou, PhD
This is an interesting epidemiological study on the association between prenatal exposure to caffeine and child’s body composition. This association between mother-child pairs is not well studied. In light of the evidence of a beneficial effect of caffeine intake in non-pregnant adults, this study is very important. The Generation R Study is a well-known and well-designed birth cohort, with a plethora of clinical outcomes and long follow-up of the study population. In this study, the high number of children participating in the 10-year follow-up and the body composition assessment via DXA, the gold standard of body composition assessment methods, as well as MRI, the gold standard of organ fat disposition assessment, is impressive.
The researchers found that maternal caffeine intake of more than 4 cups per day was associated with higher total body fat, higher disposition of fat around the abdomen (android/gynoid ratio), higher disposition of abdomen fat under the skin but above the muscles (subcutaneous) but also more fat under the muscles and around the organs (visceral), as well as around the liver. The latter associations were independent of total body fat, and this makes these findings even more important.
It is true that among women who reported consuming more than 6 units of caffeine, the prevalence of smoking and alcohol consumption in pregnancy as well as TV watching in childhood were high. This might raise issues of unmeasured confounding effects by an overall unhealthy lifestyle. It is true that such studies might always be affected by such errors, while, as the authors also explained, this is less likely as dose-response associations are found across the range of caffeine intake. Nevertheless, there is still the possibility that the observed effects might be explained by an overall unhealthy diet, rather than caffeine intake itself. Unfortunately, this was not taken into consideration.
These findings add evidence of the adverse effects of caffeine intake in pregnancy on the child’s physical development and provide important evidence linking caffeine to fat disposition around the abdomen. The children born to mothers consuming caffeine above and even below the recommendation for pregnant women could be at higher risk for developing cardiometabolic diseases. The important public health message for future mothers is that caffeine intake is a preventable, early risk factor for the development of chronic disease in adulthood, and it is important to be aware of the recommendation to reduce or even avoid caffeine consumption while pregnant.
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