Disclosures: The authors report no relevant financial disclosures.
November 23, 2021
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Drinking low levels of caffeine during pregnancy may reduce risk for gestational diabetes

Disclosures: The authors report no relevant financial disclosures.
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Women who drink caffeinated beverages within recommended guidelines may have a lower risk for gestational diabetes compared with those with no caffeine intake, according to findings published in JAMA Network Open.

In data obtained from the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons, women drinking 1 mg to 100 mg of caffeinated beverages daily at 16 to 22 weeks of pregnancy reduced their risk for gestational diabetes by 47% and also had lower glucose levels and a better fasting cardiometabolic profile compared with those who did not consume caffeinated drinks.

Pregnant women who drink 1 to 100 mg of caffeine per day have a lower risk for gestational diabetes than those who don't drink caffeine. Data were derived from Hinkle SN, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.33401.

“These findings are consistent with studies that have found that caffeine in itself has been associated with improved energy balance and decreased fat mass, which may explain the observed findings,” Stefanie N. Hinkle, PhD, assistant professor of epidemiology in the department of biostatistics, epidemiology and informatics at the University of Pennsylvania Perelman School of Medicine, told Healio. “Also, we cannot rule out that these findings are due to other constituents of coffee and tea, such as phytochemicals that may impact inflammation and insulin resistance leading to a lower risk for gestational diabetes.”

Stefanie N. Hinkle

Hinkle and colleagues analyzed data from 2,583 pregnant women in the National Institute of Child Health and Human Development Fetal Growth Studies-Singletons (mean age, 28.1 years; 28.9% Hispanic; 27.8% Black; 27.2% white). Eligible participants were free of any chronic diseases, did not smoke, did not drink more than one alcoholic beverage daily or use illicit drugs, conceived without fertility drugs or in vitro fertilization and had no prior pregnancy complications. Participants were enrolled at 12 centers in the U.S. at 8 to 13 weeks of pregnancy from 2009 to 2013. Research visits were conducted at 10 to 13 weeks, 16 to 22 weeks, 24 to 29 weeks, 30 to 33 weeks and 34 to 37 weeks. Caffeine intake was self-reported at enrollment and each visit. Plasma concentrations of caffeine and paraxanthine were measured at 10 to 13 weeks of pregnancy. Participants were screened for gestational diabetes with a 50 g glucose challenge test and a 100 g oral glucose tolerance test. Plasma fasting cardiometabolic markers were measured at 16 to 22 weeks.

Caffeine reduces gestational diabetes risk

At 10 to 13 weeks of pregnancy, 58.5% of the study cohort reported consuming at least one caffeinated beverage and 76.4% said they consumed at least one caffeinated beverage at 16 to 22 weeks. The median concentration of plasma caffeine was 169.1 ng/mL and median paraxanthine was 74.4 ng/mL at 10 to 13 weeks.

At 16 to 22 weeks, 68.3% of the study cohort consumed 1 mg to 100 mg daily of caffeinated beverages and 23.6% reported no caffeine intake. Those who drank 1 mg to 100 mg of caffeinated beverages had a lower risk for gestational diabetes compared with those who did not consume caffeine (RR = 0.53; 95% CI, 0.35-0.8). Drinking 1 mg to 100 mg of caffeine daily was also associated with lower glucose level compared with no caffeine consumption (mean difference, –2.7 mg/dL; 95% CI, –5.4 to 0).

Improvements in cardiometabolic markers

Plasma caffeine and paraxanthine were not associated with gestational diabetes risk. Caffeine intake was not associated with gestational hypertension or preeclampsia. Women who consumed 1 mg to 100 mg per day of caffeine at 16 to 22 weeks of pregnancy had lower C-reactive protein, total cholesterol, triglycerides and LDL cholesterol compared with those who did not consume caffeine.

Hinkle said the findings revealed a reduction in gestational diabetes risk with drinking a low level of caffeine, but they must be considered in the context of published data on offspring health.

“We previously found that caffeine consumption during pregnancy, even in amounts less than the recommended 200 mg per day, was associated with smaller neonatal anthropometric measurements,” Hinkle said. “Therefore, it would not be prudent for women who are nondrinkers to initiate caffeinated beverage consumption for the purpose of lowering gestational diabetes risk and improving glucose metabolism.”

For more information:

Stefanie N. Hinkle, PhD, can be reached at stefanie.hinkle@pennmedicine.upenn.edu.