Caffeine and Pregnancy: What’s the Correlation?

What Is Caffeine and How Does It Affect Your Body?

Caffeine is one of the most widely used stimulants in the world. The effects of caffeine consumption include elevated blood pressure and heart rate, increased alertness, and increased urine production. It takes around 20 minutes for effects to kick in, and many people rely on this stimulant to give them their morning or afternoon boost.

However, too much of anything can hurt you, so going over the line with caffeine can make you feel jittery, cause indigestion, or disrupt your sleep cycle.

Caffeine is found in these foods and beverages:

The amount depends on many factors like brand and the size of the product. Here is a list of caffeine content in some foods and 8-ounce drinks (1):

Can Pregnant Women Drink Coffee?

According to The American College of Obstetricians and Gynecologists (ACOG) guidelines, women can enjoy a low to moderate caffeine consumption during pregnancy. That refers to less than 200 mg per day or one or two cups of instant coffee per day. This doesn’t appear to significantly contribute to preterm birth or miscarriage, unlike high caffeine consumption (over 300 mg per day). (2)

“Extreme levels of exposure to, or consumption of, any substance may well adversely alter fetal development. Practice moderation in all matters to protect the welfare of mother and child,” said reproductive epidemiologist, Professor Michael Davies.

This caffeine consumption recommendation also relates to women who are trying to get pregnant. The early stage of fetal development is one of the critical phases, so the development mustn’t be affected in any way.

What About Energy Drinks and Other Products With Caffeine?

Energy drinks are a big no-no during pregnancy. An average can of this stuff is packed with caffeine, and pregnant women should avoid them altogether. In fact, most labels contain advisory notes to discourage pregnant and nursing women from drinking them.

Studies in mice have shown that regular energy drink consumption could lead to oxidative stress that damages the liver, kidneys, and brain. (3) In addition, it increased anxiety levels in newborn mice, which is why drinking energy drinks is highly discouraged during pregnancy and breastfeeding.

While you can consume other products that contain caffeine, it’s important to do it in moderation. As you can see in that list of caffeine content in different foods and drinks, numbers can add up pretty quickly, and you can go over the upper recommended limit of 200 mg per day. 

Why Is High Caffeine Intake During Pregnancy Dangerous?

The problem with caffeine consumption during pregnancy is that it takes more time to metabolize and eliminate it from your body. In fact, research has shown that it takes 1.5-3.5 times longer to do so. (4)

Additionally, the same study highlights caffeine’s ability to cross the placenta and enter the baby’s body. The problem with this is that the babies are unable to metabolize caffeine, and they cannot eliminate it. So, it can lead to a potential build-up and related health effects.

High caffeine intake during pregnancy has been linked with elevated catecholamine levels in mothers, higher risk of miscarriage, preterm birth, low birth weight, and other health problems.

The evidence is often contradictory, and some studies find a link between maternal caffeine consumption and poor health outcomes, while others show no such connection. Emily Mitchell, a dietitian at the Center for Fetal Medicine, advises: “The evidence of caffeine use in pregnancy is not conclusive, so it’s best to limit.”

That is why we have assessed multiple studies, meta-analyses, and different expert opinions to provide you with all the evidence out there. Of course, all of this information is not medical advice, and you should always consult with a healthcare professional about managing your pregnancy.

Now, let’s review the potential risks of high or even moderate caffeine intake during pregnancy.

Maternal Caffeine Consumption and the Risk of Miscarriage

One of the biggest fears of moms-to-be is that drinking caffeine during pregnancy can lead to miscarriage. The fear is justified, and it’s one of the main reasons why you should cut down on coffee and sodas during pregnancy.

One study showed that high caffeine intake (over 200 mg per day) lead to an increased risk of miscarriage compared to women who were consuming low or no amounts of caffeine. (5) Another study of 2407 women concluded that there is little indication of harmful effects of caffeine on increased miscarriage risk. Still, the authors also agree that reporting bias may have played a role in that. (6)

A 2015 meta-analysis showed that coffee and caffeine consumption during pregnancy seems to increase the risk of pregnancy loss. (7) With every increase of 150 mg per day, the pregnancy loss rose by 19%. Another analysis investigating the consumption of different amounts of caffeine during pregnancy and the risk of miscarriage found similar results, but only for women who consumed high levels of caffeine. (8)

However, it is important to mention that other studies found no links between maternal caffeine consumption and miscarriage. (9) Experts also point out several problems with those studies and why we get such results. For instance, they even address a recall bias where women who had to go through pregnancy loss had to recollect their caffeine intake behaviors during pregnancy, which is not the best way to collect data.

Observational studies, not including other parameters like smoking and pregnancy symptoms, and other biases is why scientists still don’t have clear conclusions. That’s why the American College of Obstetricians and Gynecologists discourages high caffeine intake during pregnancy, but after reviewing all the evidence, they believe that moderate caffeine consumption does not increase the risk of miscarriage.

Drinking Caffeine During Pregnancy and Increased Risk of Preterm Birth

Another adverse effect that has been linked to caffeine consumption during pregnancy is preterm birth. The medical field has progressed tremendously, and doctors have all the necessary tools to ensure the survival of premature babies. However, they may face an increased risk of developing respiratory problems, developmental delay, feeding issues, and other side effects, according to the CDC. (10)

Several studies found no association between caffeine consumption and increased risk of preterm birth. (11, 12) That was also confirmed by the findings of another meta-analysis, which led scientists to conclude that drinking coffee and other drinks in moderation is no risk factor for premature birth. (13) That’s also consistent with ACOG guidelines.

Caffeine and Low Birth Weight

Multiple studies examined whether caffeine had growth restriction effects on fetal development. We know that this stimulant can cross the placenta and that babies have no way of eliminating it, so it’s vital to investigate whether this can have negative consequences like growth restriction and low birth weight.

Low birth weight is associated with an increased risk of infant death. (14) These babies also have a higher chance of developing a chronic condition during adulthood. That’s why it is vital to take necessary precautions to ensure proper fetal development.

A 2014 study highlighted that high levels of caffeine consumption increased the chances of low birth weights in infants. (15) An additional 2015 study showed that even 1 cup of coffee per day could increase the chances of low birth weight by 3%. (16) That may not seem much, but if women keep consuming caffeinated foods and drinks, it could significantly increase those numbers.

However, it remains unclear whether small or moderate doses have the same adverse effects as high levels of caffeine. 

Should I Limit Caffeine Intake When Breastfeeding?

Nursing women often experience disrupted sleep cycles and temporary insomnia upon the arrival of their newborn. Lack of energy and alertness can affect mood and all other parts of life, so it’s only natural that breastfeeding women reach for caffeine to give them that jolt of energy.

However, it’s important to remember that a portion of caffeine ends up in the mother’s milk, and the baby can consume it. That can disrupt their sleep cycles and cause irritability, which will only perpetuate your ongoing struggle with a continuous state of fatigue.

That’s why it is also recommended to stick to the American College of Obstetricians and Gynecologists pregnancy guidelines of lowering caffeine intake to less than 200 mg per day. That way, you can get a little boost without risking any health effects.

Are There Any Benefits to Drinking Caffeine During Pregnancy?

Caffeine is one of the most commonly used stimulants, and it is one of the safest ones. Research shows that it stimulates your central nervous system, which results in better mental awareness and better focus. (17) It positively affects learning, memory, performance, and coordination. No wonder coffee is a go-to beverage for many students and working people when they need a little boost.

Certain types of tea and coffee are rich in antioxidants, particularly green tea. These compounds help your body protect itself against oxidative stress, which is vital for preventing chronic diseases. (18)

Caffeine is also commonly used to fight off headaches and migraines. (19)

However, all of those benefits are observed in the general population, and there seem to be no such effects in pregnant women. When considering all other potential side effects, it is safe to say that risks outweigh the benefits by far.

So, What’s the Verdict on Maternal Caffeine Consumption?

As you can see, there is a lot of information about caffeine exposure during pregnancy and risk of different adverse effects. Some of these fears are based on evidence and supported by studies. But more often, the evidence is mixed, which is why experts recommend lowering the amount of coffee, tea, chocolate, and other caffeinated products during pregnancy.

Two major studies looking into the effects of caffeine from 2017 and 2018 found that this popular stimulant is mostly safe for everyone, with few reported risks in pregnant women associated with high levels of caffeine. (20,21)

The experts mostly agree with the American College of Obstetricians and Gynecologists that you should cut down on caffeine and consume less than 200 mg per day. That should significantly decrease the risk of miscarriage, preterm birth, and lower birth weights.

Treasure McGuire, a Pharmacist, confirms the safety of moderate caffeine consumption. “Until further quality evidence resolves the safe consumption threshold, the maximum daily caffeine dose for pregnant women should ideally be (under) 200mg.”

Others like Clare Collins, a nutrition and dietetics professor, are a little more skeptical of people’s ability to estimate how much caffeine they consume accurately. She believes that saying no to caffeine exposure is the safest answer. “So while the key message is to keep total caffeine to less than 300 mg per day, the challenge is that it is almost impossible to monitor your intake accurately.”

A 2020 controversial meta-analysis has brought a lot of arguments about whether we should rethink our current guidelines. (22) The findings were published in BMJ Evidence-Based Medicine journal, and they conclude that no amount of caffeine should be considered safe for pregnant women. 

This analysis of observational studies shows that even small levels of caffeine exposure are associated with negative pregnancy outcomes. That is why pregnant women and those trying to conceive should avoid it altogether.

“Current health guidelines on caffeine consumption during pregnancy, which typically advise pregnant women to keep caffeine consumption at 200 milligrams or less a day, are in need of radical revision,” said Jack James, study author and professor of psychology at Reykjavik University in Iceland.

However, it is important to mention that this research’s nature is observational, and it can’t establish causation. Many experts took these findings with a grain of salt and were quick to point out some flaws.

Dr. Alan Leviton, a professor of neurology at Harvard Medical School, was quick to comment: “The review draws conclusions from studies that rely on self-reported consumption data, which is notoriously inaccurate.”

“The observational nature of this data with its inherent bias does not indicate with any certainty that low doses of caffeine are harmful, and the current advice to avoid high doses of caffeine are unlikely to change,” added Andrew Sherman, a professor of obstetrics.

Many other experts tuned in, agreeing that this study’s conclusions were “alarmist” and that there is no hard evidence that should support eliminating caffeine exposure altogether.

Tips for Cutting Back on Caffeine During Pregnancy

It is obviously vital to consume less caffeine during pregnancy, but if you are a caffeine junky, it may not be so easy to do so. Here are a few simple tips that should help you cut back on your caffeine fixes.

Figure Out What You Like Best About Your Caffeine Fix

Some people like the taste or smell of coffee. For others, it may be the peace of that first sip in the morning while everything is still calm and quiet. The rest may simply be tired and are looking for some extra energy. Whatever it is, know that there is an option.

If it’s the taste, buy some quality decaf blends that will provide the same experience with significantly less caffeine. If you simply like something warm in the morning, consider switching to a pregnancy-safe herbal tea blend that can offer a similar experience.

You should also limit sweets and sodas and swap them with healthy snacks with complex carbs and protein.

Don’t Go Cold Turkey

Going from five cups of coffee per day to none will have a significant effect on your body and brain. You may feel moody, exhausted, and experience terrible headaches. Pair that with pregnancy symptoms, and you’ll get a nightmare for weeks.

You can start with eliminating one cup per day or switching it to the decaf version. Go gradually until you reach one or two cups per day, and if you feel comfortable, eliminate it altogether.

Ideally, it would be best if you started doing this before trying to conceive, but it’s never too late.

Remember Other Sources of Caffeine Besides Coffee

Yes, we all know that we should cut back on coffee, but many people underestimate how much caffeine there is in tea, sodas, sweets, and other caffeinated products. Mind what you eat and drink, as those milligrams can add up quickly.

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The Verdict

If you are pregnant or trying to conceive, it is vital to learn about the changes you need to implement in your everyday diet. That may include watching your caffeine consumption, as high doses negatively affect mothers’ and babies’ health.

Most experts and guidelines worldwide agree that you should limit your caffeine intake to 200 mg per day, while some say that 300 is perfectly safe. Research supports this advice. (23)

Always talk to your doctor first, as they know about your medical history and current health status, allowing them to give you the best personalized advice. Feel free to discuss caffeine consumption with them, and figure out whether you need to cut back on those Starbucks visits.

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