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Study Title and Description

Cigarette, alcohol, and caffeine consumption: risk factors for spontaneous abortion.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on reproductive and developmental outcomes?
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Primary Publication Information
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TitleData
Title Cigarette, alcohol, and caffeine consumption: risk factors for spontaneous abortion.
Author V Rasch,
Country
Year 2003
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Reproductive Toxicity - Design Details
Arms
No arms have been defined in this extraction form.

Design Details
Question... Follow Up Answer Follow-up Answer
Refid 12648183
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What outcome is being evaluated in this paper? Reproductive and Development
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What is the objective of the study (as reported by the authors)? The aim of this study was to further explore the relationships between cigarette, alcohol, and caffeine consumption and the occurrence of spontaneous abortion.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Cases (n = 330) were women with spontaneous abortion in gestational week 6–16; pregnant women in gestational week 6–16 served as controls (1168). All participants were asked to fill in a structured questionnaire anonymously. Women having spontaneous abortion filled in the questionnaire after they had been diagnosed as having a spontaneous abortion and returned it before they left the hospital. Women attending antenatal care filled in the questionnaire in relation to their first antenatal care visit. The number of cups of coffee, tea, and chocolate as well as the number of cola and the number of chocolate bars (50 mg) consumed per day during the pregnancy were recorded. Each woman’s daily caffeine intake was estimated assuming the content of caffeine to be 100 mg in one cup of coffee, 50 mg in one cup of tea, 25mg in one cup of chocolate, 100 mg in 0.25 L of cola and 12.5mg in a 50 gram chocolate bar. Odds ratio (OR) was calculated by a case-control approach using women with spontaneous abortion as cases in comparison with women receiving antenatal care.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) SA
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes spontaneous abortion in gestational week 6–16,
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Clinical Clinical
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Physiological
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Other
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What is the study design? Case-Control
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description Cases had an evacuation procedure performed
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Caffeine (general) Caffeine (general)
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Coffee Coffee
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Chocolate Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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Soda Soda
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Tea Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults
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Pregnant Women Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) Mean daily caffeine: 0–199 mg/day, 200–374 mg/day, and >/=375 mg/day
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) maternal age, parity and occupation was controlled by including these factors together with cigarette, alcohol, and caffeine consumption
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Provide a general description of results (as reported by the authors). Women who consumed 375 mg or more caffeine per day had more than twofold increased OR for having spontaneous abortions in comparison with women who consumed 0–199mg caffeine per day. This association remained significant in the adjusted analyzes. Consumption of 200–374mgcaffeine per day was not found to be associated with the occurrence of spontaneous abortion. Stratified analyzes of caffeine consumption on the basis of cigarette consumption showed that both women who smoked and women who consumed alcohol were more likely to report a higher level of caffeine intake than women who did not smoke and women who did not consume alcohol, respectively. who did not smoke but consumed 375mg or more caffeine per day, had an almost three times increased OR for having a spontaneous abortion. Women who smoked and consumed 375 mg or more caffeine per day did also have increased OR for having spontaneous abortions, the association, however, was less pronounced and not statistically significant. Stratification based on alcohol consumption showed that women who consumed 375 mg caffeine or more per day had a more than twofold increased OR for having a spontaneous abortion, regardless of whether they consumed alcohol or not.
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? The results from the present study are in accordance with this assertion as both smoking women and alcohol consuming women reported higher caffeine consumption in comparison with non smoking and non alcohol consuming women, respectively. Regardless of smoking and alcohol status, however, women who consumed 375 mg caffeine or more per day had increased ORs for having spontaneous abortions. Moderate caffeine consumption(201–374 mg per day) was not associated with increased an OR for having spontaneous abortion.
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What were the sources of funding? The study was funded by grants from University of Southern Denmark.
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What conflicts of interest were reported? None reported
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Does the exposure (dose) need to be standardized to the SR? No
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest).
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  LOAEL = >/= 375 mg/day; NOAEL = 200-374 mg/day. For >/= 375 mg/day, adjusted OR = 2.21 (95% CI, 1.53-3.18).
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. content of caffeine to be 100 mg in one cup of coffee, 50 mg in one cup of tea, 25mg in one cup of chocolate, 100 mg in 0.25 L of cola and 12.5mg in a 50 gram chocolate bar
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What is the importance of the study with respect to the adverseness of the outcome? Important
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Baseline Characteristics
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Results & Comparisons

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