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Meta-Analysis
. 2015 Jul 20;10(7):e0132334.
doi: 10.1371/journal.pone.0132334. eCollection 2015.

Maternal Caffeine Consumption during Pregnancy and Risk of Low Birth Weight: A Dose-Response Meta-Analysis of Observational Studies

Jongeun Rhee  1 , Rockli Kim  2 , Yongjoo Kim  2 , Melanie Tam  3 , Yizhen Lai  4 , NaNa Keum  5 , Catherine Elizabeth Oldenburg  6
Affiliations
Meta-Analysis

Maternal Caffeine Consumption during Pregnancy and Risk of Low Birth Weight: A Dose-Response Meta-Analysis of Observational Studies

Jongeun Rhee et al. PLoS One. .

Abstract

Epidemiologic studies have shown inconsistent conclusions about the effect of caffeine intake during pregnancy on the risk of low birth weight (LBW). We performed a meta-analysis and linear-dose response analysis examining the association between caffeine consumption during pregnancy and risk of LBW. PubMed and EMBASE were searched for relevant articles published up to March 2014. Eight cohort and four case-control studies met all inclusion criteria. Using a random-effects model of the twelve studies, the pooled odds ratio (OR) for the risk of LBW comparing the highest versus lowest level of caffeine intake during pregnancy was 1.38 (95% CI: 1.10, 1.73). Linear dose-response analysis showed that every additional 100 mg of caffeine intake (1 cup of coffee or 2 cups of tea) per day during pregnancy was associated with a 3.0% increase in OR for LBW. There was a moderate level of overall heterogeneity with an I-squared value of 55% (95% CI: 13, 76%), and no evidence of publication bias based on Egger's test (P = 0.20) and the funnel plot. Thus, high caffeine intake during pregnancy is associated with a significant increase in the risk of LBW, and this risk appears to increase linearly as caffeine intake increases.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Literature search results for publications related to caffeine consumption during pregnancy and risk of low birth weight.
Fig 2
Fig 2. Forest plot of meta-analysis by using random effects model for the effect of maternal caffeine intake during pregnancy on the risk of low birth weight (comparing highest versus lowest levels).
Fig 3
Fig 3. Forest plot of meta-analysis by using random effects model for the effect of maternal caffeine intake during pregnancy on the risk of low birth weight (comparing highest versus lowest levels) among cohort studies.
Fig 4
Fig 4. Forest plot of meta-analysis by using random effects model for the effect of maternal caffeine intake during pregnancy on the risk of low birth weight (comparing highest versus lowest levels) among case-control studies.
Fig 5
Fig 5. Linear dose-response analysis on the effect of caffeine intake during pregnancy on low birth weight.
Fig 6
Fig 6. Funnel plot of meta-analysis on the effect of caffeine intake during pregnancy on low birth weight.
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