Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome

Background Maternal caffeine consumption during pregnancy may have adverse effects on fetal, neonatal and maternal outcomes. Objectives This review investigates the effects of restricting caffeine intake by mothers on fetal, neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2012), scanned bibliographies of published studies and corresponded with investigators. Selection criteria Randomised controlled trials (RCTs) including quasi-RCTs investigating the effect of caffeine and/or supplementary caffeine versus restricted caffeine intake or placebo on pregnancy outcomes. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Main results Two studies met the inclusion criteria but only one contributed data for the prespecified outcomes. Caffeinated instant coffee (568 women) was compared with decaffeinated instant coffee (629 women) and it was found that reducing the caffeine intake of regular coffee drinkers (3+ cups/day) during the second and third trimester by an average of 182 mg/day did not affect birthweight or length of gestation. Authors' conclusions There is insufficient evidence to confirm or refute the effectiveness of caffeine avoidance on birthweight or other pregnancy outcomes. There is a need to conduct high-quality, double-blinded RCTs to determine whether caffeine has any effect on pregnancy outcome.