Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcomes

Shayesteh Jahanfar, Sharifah Halimah Jaafar
  • Cochrane Database of Systematic Reviews, June 2015, Wiley
  • DOI: 10.1002/14651858.cd006965.pub4

Coffee and pregnancy outcomes

What is it about?

It’s not unusual for pregnant women to wonder whether taking their regular, everyday coffee could have an impact on their fetus. And, what about other forms of caffeine such as tea, cola, chocolate and some over-the-counter medicines? Alongside these uncertainties, it is known that caffeine clears more slowly from the blood during pregnancy, which could lead to even stronger effects. Sharifah Halimah Jaafar, from the KPJ Johor Specialist Hospital in Malaysia, and I did this Cochrane Review to answer these questions, but we’ve found that the evidence is currently too weak to be sure.

Why is it important?

Before doing the review, we knew that some studies had suggested that caffeine intake is harmful to the fetus, causing growth restriction, reduced birthweight, preterm birth or stillbirth. While other investigators failed to find any association between caffeine intake and these or other poor pregnancy outcomes. We wanted to see what the answer would be when we brought together the most reliable studies of the impact of restricted maternal caffeine consumption during pregnancy on fetal, neonatal and pregnancy outcomes.


Dr Shayesteh Jahanfar
University of British Columbia

This lack of high quality randomized trials means that we still don’t know the truth about the impact of coffee consumption during pregnancy. Six years after publishing the first version of this review, and after two updates, the implications of our findings remain the same: we need some large, high quality randomised trials. And, these trials need to measure outcomes of particular importance to women and their families and to the practitioners who provide care during their pregnancy, such as miscarriage, low birth weight, preterm birth, perinatal mortality, sudden infant death syndrome and maternal diabetes. However, we recognise that doing these trials will be challenging. Long-term outcome measures in evaluating caffeine intake during pregnancy may be difficult or even unethical. In order to impact outcomes such as miscarriage or birth defects, changes in coffee drinking might need to happen before pregnancy or in very early pregnancy. Furthermore, it’s not clear how much caffeine, in what shape or form, with what quality, can cause fetal or maternal problems, if any. In summary, we sadly still don’t know all that much about the effect of restricting coffee during pregnancy, and we hope that our future updates might contain the evidence needed to help resolve the uncertainties.”

Read Publication


The following have contributed to this page: Dr Shayesteh Jahanfar and Professor Dr. Shayesteh Jahanfar