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Study Title and Description

Maternal smoking, alcohol consumption, and caffeine consumption during pregnancy in relation to a son's risk of persistent cryptorchidism: a prospective study in the Child Health and Development Studies cohort, 1959-1967.



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 Maternal smoking, alcohol consumption, and caffeine consumption during pregnancy in relation to a son's risk of persistent cryptorchidism: a prospective study in the Child Health and Development Studies cohort, 1959-1967.
Author ML Mongraw-Chaffin,BA Cohn,RD Cohen,RE Christianson,
Country
Year 2008
Numbers

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


Extraction Form: Reproductive Toxicity - Design Details
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 18024986
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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)? In the present study, we investigated associations of maternal smoking, alcohol consumption, and caffeine consumption with persistent cryptorchidism in a large prospective pregnancy cohort, the Child Health and Development Studies (CHDS).
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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) Subjects in this study were the sons of women who participated in the CHDS. Cryptorchidism was defined as one or two undescended testicles present at both birth and 2 years of age (n . 101). We required presence of the condition at age 2 years specifically to examine risk factors for persistent cryptorchidism. For each of the 84 remaining cases, three noncases (controls) were identified who matched the case on race/ethnicity and date of birth. Caffeine was assessed by a structured interview conducted during early pregnancy. Caffeine intake was derived by assuming that an 8-ounce serving of coffee contained 135 mg of caffeine and an 8-ounce serving of tea contained 43.75 mg of caffeine. To obtain total caffeine intake in milligrams per day, the reported number of cups of coffee drunk per day multiplied by 135 was added to the reported number of cups of tea drunk per day multiplied by 43.75. This figure was rescaled by dividing it by 135, making one unit on the new scale the equivalent of one serving of coffee. Associations between case status and the primary risk factors were examined by using conditional logistic regression analysis. Where possible, models contained continuous variables and the interquartile range was used to determine an odds ratio. Models provided maximum likelihood estimates of odds ratios and approximate 95 percent confidence intervals. Unadjusted, bivariate, and multivariate models were examined
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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) Cryptorchidism
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes Cryptorchidism was defined as one or two undescended testicles present at both birth and 2 years of age - "persistent cryptorchidism"
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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 Methods not described - assumed to be clinically confirmed
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Caffeine (general) Caffeine (general)
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Coffee Coffee
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Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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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.) 3 equivalent cups of coffee/day (= 405 mg/day caffeine), (defined as an interquartile range)
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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 alcohol consumption, smoking, caffeine consumption, body mass index, and son’s birth weight
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Provide a general description of results (as reported by the authors). A significant association was found for caffeine consumption, both before and after adjustment for alcohol consumption, smoking, birth weight, and body mass index. Compared with mothers of controls, mothers of cryptorchid boys consumed more caffeine during pregnancy (odds ratio = 1.4, 95% confidence interval: 1.1, 1.9 for an interquartile range equivalent to three cups of coffee per day).
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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? We observed a significantly increased risk of cryptorchidism for sons of mothers who consumed more caffeine during pregnancy.
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What were the sources of funding? This project was made possible by funding from the Lance Armstrong Foundation and the National Institutes of Health (N01 DK63422).
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What conflicts of interest were reported? point of view and conclusions expressed in this paper are those of the authors and do not necessarily represent the official position or policies of the Lance Armstrong Foundation. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. Conflict of interest: none declared.
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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.  (persistent) cryptorchidism LOAEL = 405 mg/day caffeine
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. REVIEWER CALCULATED: 3 equivalent cups of coffee/day = 405 mg/day caffeine Caffeine intake was derived by assuming that an 8-ounce serving of coffee contained 135 mg of caffeine and an 8-ounce serving of tea contained 43.75 mg of caffeine. To obtain total caffeine intake in milligrams per day, the reported number of cups of coffee drunk per day multiplied by 135 was added to the reported number of cups of tea drunk per day multiplied by 43.75. This figure was rescaled by dividing it by 135, making one unit on the new scale the equivalent of one serving of coffee.
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What is the importance of the study with respect to the adverseness of the outcome? Critcal
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