Caffeine Risks during Pregnancy Aric Quist Extra credit paper

In the textbook Drugs, Behavior, & Modern Society by Levinthal multiple risks during pregnancy were outlined in regards to caffeine use. This was a topic that I found interesting because my wife is currently pregnant, and she has been advised to abstain from drinking caffeine. Studies have shown that caffeine consumption (more than three or four cups of coffee a day) during the first three months of pregnancy is related to a greater incidence of low birth weight in the newborn, although the incidence of premature birth or birth defects is not increased (Levinthal, 2012). There is also a relationship between very high levels of caffeine consumption (more than six cups of coffee per day) during pregnancy and an increased risk of miscarriage. This demonstrates that the cautionary advice of the FDA is warranted and women should abstain from caffeine if at all possible during pregnancy. To better examine the dangers of caffeine consumption while pregnant I turned to the study Caffeine Use Affects Pregnancy Outcome (Diego, Field, Hernandez-Reif, Vera, Gil & Conzalez-Garcia, 2007) which sampled 750 healthy pregnant women. Of the women 56% were Hispanic, 34% were African American and 10% were Caucasian. Regarding their living arrangements 26% were single and living alone, 68% were living with a significant other and 6% were divorced. They measured the women using three different self-reported scales measuring depression, anxiety, and sleep effectiveness. When examining the results they found that divorced women drank significantly less caffeinated drinks than single women or those living with a significant other. They also found that Caucasian women drank the most caffeine, African American women drank less, and Hispanic women consumed the least amount of caffeine. When comparing their caffeine consumption with their self-reported scales they found that those women who drank more caffeine also reported being more depressed, were more anxious, had

less sleep effectiveness and were more likely to use cigarettes during pregnancy. Consuming more caffeine was also correlated with lower birth weight babies. Although this study highlights some key points and examined caffeine consumption in correlation with depression, anxiety, and sleep effectiveness, there are multiple confounding variables that need to be addressed before concluding causation between increased caffeine consumption and unhealthy side effects in the fetus. In the study they stated that caffeine consumption during pregnancy was correlated with cigarette use and symptoms of depression and anxiety (Diego, et al., 2007). While a correlation was found this does not imply causation. Caffeine consumption and cigarettes can be forms of self-medication that the women are using in order to lower their feelings of already existing depression and anxiety. If the women have symptoms of depression and anxiety this can cause added stress on the mother which can harm the fetus as much, if not more, than their caffeine consumption. Because this is an observational study, and the researchers could not directly influence the mothers feelings of depression, anxiety, or caffeine consumption, there is no way to determine causation of the harmful side effects on the baby from caffeine or another factor. Another confounding variable is that the women were predominantly lower to middle socio economic status; and the majority of them had graduated high school with 23% having 1-3 years of college education. The majority of women fell into lower to middle socio economic status which can cause added stress due to cultural standards and lack of financial funding. Although the majority of them graduated high school, less than a quarter of them had any college experience which means they probably are not in high paying careers which can add to their financial stress. Especially for pregnant women in lower social economic status, most do not have the luxury of quitting their job when they get pregnant and therefore create more stress on

themselves concerning their job whereas those in middle to high socio economic status generally do not have that added stress on the fetus. The last factor that must be taken into account when regarding this study is the sample size. Although 750 women is a substantial number of women, more need to be studied in order to be able to generalize the results of the study to the broad public. Another issue is that the study did not specify where the women were from, where they were born and raised, if they were first or second generation American citizens, or their cultural background. While distinctions were made using their race, differentials in their cultural norms and expectations were not noted. Although the textbook and additional research articles highlight many important aspects, too many confounding variable are present in order to establish causation between increased caffeine intake and unhealthy side effects seen in babies. The textbook talks about caffeine intake regarding beverages, however it does not discuss caffeines risk during pregnancy in forms of chocolate and other common products. Another area of research that is lacking in information is the effect decaffeinated drinks have on the mother and on the fetus. Although they do not have caffeine, research needs to be conducted to see if the other ingredients pose any unhealthy side effects that could possibly be more harmful than caffeine. Alcohol, cigarette, and drug consumption during pregnancy is commonly known to be extremely damaging to the fetus; the side effects of caffeine, on the other hand, are less commonly known. Keeping caffeine intake to a minimum and not exceeding three cups a day of caffeinated drinks is one approximation, and a good guideline; but until further research is examined no definite outline and consumption suggestion can be determined at this time.

References Diego, M., Field, T., Hernandez-Reif, M., Vera, Y., Gil, K., & Gonzalez-Garcia, A. (2007). Caffeine use affects pregnancy outcome. Journal of Child & Adolescent Substance Abuse, 41-49. Levinthal, C. (2012). Drugs, Behavior & Modern Society. Massachusetts: Pearson.