Maternal caffeine consumption and risk of cardiovascular malformations

Maternal Caffeine Consumption and Risk of Cardiovascular Malformations Caffeine is commonly consumed during pregnancy, therefore even a small increase in risk of congenital anomalies would have an important effect on public health. A systematic review of the literature was conducted and suggested that uncertainty about small to moderate increases in risk of congenital anomalies as a result of maternal caffeine exposure cannot be discounted based on the studies published to date. Examination of caffeine consumption and risk of two pathogenetic categories of cardiovascular malformations (CVMs) in the National Birth Defects Prevention Study was undertaken. Exposures to caffeine and to each type of caffeinated beverage (coffee, tea, soda) were examined for specific conotruncal CVMs (outflow tract defects) and for septal or obstructive CVMs ("flow" defects). Smoking, alcohol, vasoactive medications, folic acid supplement use, and infant sex were evaluated for effect modification. A few unexpected patterns of association were observed for conotruncal CVM and for atrial septal defects but these findings may reflect possible biases or chance. Overall, the results of this study suggest there is little evidence for an appreciable teratogenic effect of caffeine with regard to conotruncal, septal, and obstructive CVMs.