Background: Maternal caffeine consumption during pregnancy directly affects the developing fetus as caffeine is rapidly absorbed in the maternal gastrointestinal tract and freely passes across the placenta. There is much concern about the affect of caffeine on reproductive outcomes prior to pregnancy and increased rates of fetal death. Since the 1980s, numerous studies have been published on caffeine intake during pregnancy and the risk of miscarriage and stillbirths. However, a clear consensus on whether caffeine posses these risks has yet to be determined. A systematic review of the literature using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool developed by the GRADE Working Group will be conducted to determine an accepted conclusion to this topic.
Method: An exhaustive search of available medical literature was conducted using the following databases; Medline, PubMed, Cochrane Systematic Reviews, and CINAHL.
Results: A total of five studies, four cohort and one case-control, were reviewed in their entirety. These studies looked at the relationship between caffeine intake during pregnancy and its proposed associations to an increase risk of miscarriage and stillbirth rates.
Conclusion: Based on the combined results there is still much uncertainty. Four studies, all demonstrate a dose-response related effect on caffeine and negative pregnancy outcomes. Only one study did not show a relationship between caffeine and miscarriages or stillbirths. The final GRADE for this review is moderate.
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