Caffeine in Pregnancy: Safe or Unsafe?

Coffee consumption in Asia is expected to grow by about five to ten percent annually, driven by the westernization of societies. Once not a significant issue, caffeine intake is now becoming a real health concern for this region, and indeed globally. Studies have been conducted worldwide into the effects of caffeine on the body, with a particular focus on pregnancy. Whilst limitations in the research have made it difficult to prove the dangers of caffeine in pregnancy, the widespread opinion suggests unlimited caffeine is not safe for the unborn child.


What is caffeine?

Caffeine is a naturally occurring substance derived from the leaves, seeds, and fruits of certain plants. It is commonly found in coffee, tea, chocolate, cola, and energy drinks, and can also be found in over-the-counter cold remedies. It is well-known to have a stimulant effect and increase alertness, but it can also contribute to restlessness and sleep problems.

What risks does caffeine pose in pregnancy?

In pregnancy, caffeine passes through the mother’s blood to the placenta. The fetus is unable to break down the caffeine and is thus exposed to its effects. There is some debate over what these effects are, with research having been conducted into the following risks:

·   Miscarriage: Whilst some studies have shown a strong link between high caffeine intake and miscarriage others have not, research published in the American Journal of Obstetrics and Gynecology showed that women could double their risk of miscarriage if they drank more than 200mg of caffeine a day. However, a contrasting study published in Epidemiology showed that there was no increased risk of miscarriage in women who drank between 200-350mg of caffeine a day.  

·  Preterm birth: A study published in 2010 in the American Society for Nutrition Analysis found no evidence that high caffeine consumption leads to preterm birth.

· Reduced birth weight: Most studies point towards a positive relationship between high caffeine intake and reduced birth weight. For example, research published in the British Medical Journal in 2008 showed that high caffeine consumption is associated with increased risk of fetal growth restriction. And another more recent study from Norway substantiates this and goes further to suggest that an intake of just 200mg of caffeine a day can increase the risk of giving birth to a lighter baby. Reduced birth weight can lead to medical problems at birth and also long-term health issues.

What are the recommended limits of caffeine intake during pregnancy?

In view of this research, both the European Food Safety Authority and the American College of Obstetricians and Gynecologists suggest a safe limit of 200mg of caffeine per day. Decaffeinated coffee offers a safer alternative to caffeinated drinks in pregnancy. An American study published in Epidemiology found that women consuming decaffeinated coffee showed no adverse effects in terms of birth weight or gestational age. In addition to decaffeinated drinks, herbal beverages and fruit juices are recommended as safe options.

What should pregnant women do?

Whilst the debate rages on as to the exact risks imposed by caffeine in pregnancy, there is a definite need for caution. It’s imperative that pregnant women are educated about the risks so that they can be aware of the caffeine content of food and drink, and modify their intake in line with recommended limits.

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