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Caffeine Consumption (caffeine + consumption)
Selected AbstractsCaffeine consumption and methotrexate dosing requirement in psoriasis and psoriatic arthritisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2007David L. Swanson MD Background, Recent animal and human studies have suggested that the therapeutic benefit of methotrexate in the treatment of rheumatoid arthritis may be substantially reduced in patients who are concomitantly consuming caffeine. Here, we aimed to investigate the effect of caffeine consumption on the methotrexate dosing requirements in patients with psoriasis and psoriatic arthritis. Methods, One hundred and fifty patients with diagnoses of psoriasis or psoriatic arthritis were surveyed for their current weekly methotrexate dosage and their usual daily consumption of caffeine. Results, Seventy-five of the patients given the survey responded; of these, 11 were eliminated because they did not report their methotrexate dosage or were no longer taking methotrexate. Of the remaining 64 patients, no correlation was found between the methotrexate dosage needed for disease maintenance and the amount of caffeine consumed. Conclusions, Our findings suggest that caffeine does not affect methotrexate dosage requirements in patients with psoriasis and psoriatic arthritis. These results do not rule out an effect of caffeine in other inflammatory diseases treated with methotrexate. [source] Caffeine, cognitive failures and health in a non-working community sampleHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2009Andrew P Smith Abstract Rationale Most studies of the effects of caffeine on performance have been conducted in the laboratory and further information is required on the real-life effects of caffeine consumption on cognition. In addition, possible effects of caffeine consumption on a range of health outcomes should also be assessed in these studies to enable cost-benefit analyses to be conducted. Objectives Secondary analyses of a large epidemiological database (N,=,3223 non-working participants, 57% female, with a mean age of 49.6 years, range 17,92 years) were conducted to examine associations between caffeine consumption (mean caffeine consumption was 140,mg/day, range 0,1800,mg) and cognitive failures (errors of memory, attention and action) in a non-working sample. Associations between caffeine consumption and physical and mental health problems were also examined. Methods The study involved secondary analyses of a database formed by combining the Bristol Stress and Health at Work and Cardiff Health and Safety at Work studies. Associations between caffeine consumption and frequency of cognitive failures and health outcomes were examined in a sample of non-workers. Results After controlling for possible confounding factors significant associations between caffeine consumption and fewer cognitive failures were observed. Initial analyses suggested that many health variables were associated with regular level of caffeine consumption. However, most of the significant effects of caffeine disappeared when demographic and lifestyle factors were controlled for. Consumption of caffeine was, however, associated with a reduced risk of depression. These effects were also observed in separate analyses examining the source of the caffeine (coffee and tea). Conclusions Overall, the results show that caffeine consumption may benefit cognitive functioning in a non-working population. This confirms earlier findings from working samples. This beneficial effect of caffeine was not associated with negative health consequences. Indeed, consumption of caffeine was found to be associated with a reduced risk of depression. Copyright © 2008 John Wiley & Sons, Ltd. [source] Caffeine levels in saliva: associations with psychosocial factors and behavioural effectsHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2001Carolyn Brice Abstract The present study had two main aims. The first was to examine associations between psychosocial factors, health-related behaviours, regular level of caffeine consumption, time of day and levels of caffeine in saliva following acute caffeine challenges. The second aim was to determine whether individual differences in changes in performance following ingestion of caffeine were related to levels of caffeine in saliva. One hundred and forty-four young adults participated in the study. Questionnaires were administered prior to the study to measure psychosocial characteristics, health-related behaviours and habitual levels of caffeine consumption. Two double-blind acute caffeine challenges were then carried out 1 week apart. Volunteers were given either placebo or 1.5 or 3,mg/kg of caffeine on each occasion. The challenges were carried out at 8,:,00, 11,:,00, 14,:,00 or 18,:,00,h so that the impact of time of day could be assessed. In the week between the two challenges the volunteers consumed either caffeinated or decaffeinated products. This allowed investigation of the effects of caffeine withdrawal on caffeine metabolism. Prior to each caffeine challenge volunteers performed a range of tasks, and a baseline saliva sample was taken. The tasks were repeated 1,h after ingestion of the caffeine, with saliva samples being taken at the start and end of the 1,h test battery. The results showed that the level of caffeine in the saliva was a good indicator of the dose of caffeine consumed and of compliance with the withdrawal manipulation. Caffeine levels were not influenced by time of day, habitual caffeine consumption, psychosocial factors or health-related behaviours. Individual differences in caffeine levels in saliva were not related to the individual variation in the effects of caffeine on performance. Copyright © 2001 John Wiley & Sons, Ltd. [source] The effects of caffeine on simulated driving, subjective alertness and sustained attentionHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2001Carolyn Brice Abstract There is evidence that caffeine increases alertness and reduces fatigue. This may be especially so in low arousal situations (e.g. working at night or for prolonged hours). Caffeine has also been found to improve performance on vigilance tasks and simple tasks requiring sustained response. Again, these effects are often clearest when alertness is reduced, although there is evidence that benefits may still occur when the individual is unimpaired. Most studies to date have investigated the behavioural effects of caffeine in laboratory experiments using artificial tasks. In the current study 3,mg/kg caffeine was found to improve steering accuracy in a 1,h simulated drive. Measures of mood and performance on a sustained attention task also showed the benefits of caffeine. These findings suggest that laboratory results reflect a general benefit of caffeine that may also be observed in real-life situations. Other evidence examining the effects of caffeine on performance efficiency over the working day has shown the benefits of caffeine consumption on measures of sustained attention and alertness. This study also provided evidence suggesting that caffeine is often consumed when alertness is low to maximise alertness and performance efficiency. The implications of these findings for road safety are also considered. Copyright © 2001 John Wiley & Sons, Ltd. [source] Coffee, tea, caffeine and risk of breast cancer: A 22-year follow-upINTERNATIONAL JOURNAL OF CANCER, Issue 9 2008Davaasambuu Ganmaa Abstract The relation between consumption of coffee, tea and caffeine and risk of breast cancer remains unsettled. We examined data from a large, long-term cohort study to evaluate whether high intake of coffee and caffeine is associated with increased risk of breast cancer. This was a prospective cohort study with 85,987 female participants in the Nurses' Health Study. Consumption of coffee, tea and caffeine consumption was assessed in 1980, 1984, 1986, 1990, 1994, 1998 and the follow-up continued through 2002. We documented 5,272 cases of invasive breast cancer during 1,715,230 person-years. The multivariate relative risks (RRs) of breast cancer across categories of caffeinated coffee consumption were: 1.0 for <1cup/month (reference category), 1.01 (95% confidence interval: 0.92,1.12) for 1 month to 4.9 week, 0.92 (0.84,1.01) for 5 week to 1.9 days, 0.93 (0.85,1.02) for 2,3.9 days, 0.92 (0.82,1.03) for ,4 cups per day (p for trend = 0.14). Intakes of tea and decaffeinated coffee were also not significantly associated with risk of breast cancer. RRs (95% CI) for increasing quintiles of caffeine intake were 1.00, 0.98 (0.90,1.07), 0.92 (0.84,1.00), 0.94 (0.87,1.03) and 0.93 (0.85,1.01) (p for trend = 0.06). A significant inverse association of caffeine intake with breast cancers was observed among postmenopausal women; for the highest quintile of intake compared to the lowest RR 0.88 (95% CI = 0.79,0.97, p for trend = 0.03). We observed no substantial association between caffeinated and decaffeinated coffee and tea consumption and risk of breast cancer in the overall cohort. However, our results suggested a weak inverse association between caffeine-containing beverages and risk of postmenopausal breast cancer. © 2008 Wiley-Liss, Inc. [source] Carotenoids/vitamin C and smoking-related bladder cancerINTERNATIONAL JOURNAL OF CANCER, Issue 3 2004J. Esteban Castelao Abstract Previous epidemiological studies of fruit and vegetable intake and bladder cancer risk have yielded inconsistent results, especially with respect to the role of cigarette smoking as a possible modifier of the diet-bladder cancer association. A population-based case-control study was conducted in nonAsians of Los Angeles, California, which included 1,592 bladder cancer patients and an equal number of neighborhood controls matched to the index cases by sex, date of birth (within 5 years) and race between January 1, 1987 and April 30, 1996. Information on smoking, medical and medication history, and intake frequencies of food groups rich in preformed nitrosamines, vitamins A and C and various carotenoids, were collected through in-person, structured interviews. Beginning in January 1992, all case patients and their matched control subjects were asked for a blood sample donation at the end of the in-person interviews for measurements of 3- and 4-aminobiphenyl (ABP) hemoglobin adducts, and glutathione S -transferases M1/T1/P1 (GSTM1/T1/P1) and N -acetyltransferase-1 (NAT1) genotypes. Seven hundred seventy-one (74%) case patients and 775 (79%) control subjects consented to the blood donation requests. In addition, all case patients and matched control subjects were asked to donate an overnight urine specimen following caffeine consumption for measurements of cytochrome P4501A2 (CYP1A2) and N -acetyltransferase-2 (NAT2) phenotypes. Urine specimens were collected from 724 (69%) case patients and 689 (70%) control subjects. After adjustment for nondietary risk factors including cigarette smoking, there were strong inverse associations between bladder cancer risk and intake of dark-green vegetables [p value for linear trend (p) = 0.01], yellow-orange vegetables (p = 0.01), citrus fruits/juices (p = 0.002) and tomato products (p = 0.03). In terms of nutrients, bladder cancer risk was inversely associated with intake of both total carotenoids (p = 0.004) and vitamin C (p = 0.02). There was a close correlation (r = 0.58, p = 0.0001) between intakes of total carotenoids and vitamin C in study subjects. When both nutrients were included in a multivariate logistic regression model, only total carotenoids exhibited a residual effect that was of borderline statistical significance (p = 0.07 and p = 0.40 for total carotenoids and vitamin C, respectively). Cigarette smoking was a strong modifier of the observed dietary effects; these protective effects were confined largely to ever smokers and were stronger in current than ex-smokers. Smokers showed a statistically significant or borderline statistically significant decrease in 3- and 4-aminobiphenyl (ABP)-hemoglobin adduct level with increasing intake of carotenoids (p = 0.04 and 0.05, respectively). The protective effect of carotenoids on bladder cancer seemed to be influenced by NAT1 genotype, NAT2 phenotype and CYP1A2 phenotype; the association was mainly confined to subjects possessing the putative NAT1 -rapid, NAT2-rapid and CYP1A2-rapid genotype/phenotype. The carotenoid-bladder cancer association was not affected by the GSTM1, GSTT1 and GSTP1 genotypes. © 2004 Wiley-Liss, Inc. [source] Caffeine consumption and methotrexate dosing requirement in psoriasis and psoriatic arthritisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2007David L. Swanson MD Background, Recent animal and human studies have suggested that the therapeutic benefit of methotrexate in the treatment of rheumatoid arthritis may be substantially reduced in patients who are concomitantly consuming caffeine. Here, we aimed to investigate the effect of caffeine consumption on the methotrexate dosing requirements in patients with psoriasis and psoriatic arthritis. Methods, One hundred and fifty patients with diagnoses of psoriasis or psoriatic arthritis were surveyed for their current weekly methotrexate dosage and their usual daily consumption of caffeine. Results, Seventy-five of the patients given the survey responded; of these, 11 were eliminated because they did not report their methotrexate dosage or were no longer taking methotrexate. Of the remaining 64 patients, no correlation was found between the methotrexate dosage needed for disease maintenance and the amount of caffeine consumed. Conclusions, Our findings suggest that caffeine does not affect methotrexate dosage requirements in patients with psoriasis and psoriatic arthritis. These results do not rule out an effect of caffeine in other inflammatory diseases treated with methotrexate. [source] Systematic review on the effectiveness of caffeine abstinence on the quality of sleepJOURNAL OF CLINICAL NURSING, Issue 1 2009Celia WM Sin Aim., The aim of the present study is to review the effects of caffeine abstinence on the quality of sleep. Background., Insomnia is a common problem and abstinence from caffeine is the most popular component in sleep hygiene advice. However, there have been inconsistent results relating to the effectiveness of caffeine abstinence in improving sleep. Design., Systematic review. Methods., We browsed several electronic databases and reference lists of articles about the correlation of caffeine consumption and sleep deprivation. We selected the articles according to predefined inclusion and exclusion criteria. Two reviewers assessed the quality of trials, which were selected according to the Jadad quality assessment scale. We included the trials scoring three or above in the systematic review and extracted their data. We assessed the heterogeneity of the studies before we considered whether or not to combine the studies' results. Results., Three randomised control trials fulfilled the selection criteria among which two trials scored ,3 on the Jadad scale. We included these two trials in our systematic review. The designs and outcome measurements of these two trials were not homogeneous, therefore, we did not combine their results. Instead, we conducted a critical appraisal. In one trial, caffeine abstinence was associated with significant lengthening of sleep duration (p < 0·01) and better sleep quality (p < 0·05). In another trial, subjects had less difficulty falling asleep on days when they drank decaffeinated coffee (p < 0·05). Conclusions., The results showed that caffeine abstinence for a whole day could improve sleep quality. Thus, health practitioners were recommended to include caffeine abstinence in the instructions for sleep hygiene. Relevance to clinical practice., This study demonstrates the effectiveness of caffeine abstinence in improving sleep quality. It provides evidence for the practice of including caffeine abstinence in sleep hygiene advice. [source] Semiquantitative study of current coffee, caffeine, and ethanol intake in essential tremor cases and controlsMOVEMENT DISORDERS, Issue 5 2004Elan D. Louis MD Abstract There are several reasons to study caffeine, coffee, and ethanol intake in essential tremor (ET) patients. ET patients also might modify their use of these beverages because of their effects on tremor. Intake of caffeine, coffee, and ethanol has not been quantified in a group of ET patients. Our objective is to use a semiquantitative food frequency questionnaire to compare current daily intake of coffee, caffeine, and ethanol in ET patients and controls. A total of 130 ET cases were patients at the Neurological Institute of New York, and 175 controls were ascertained by random digit dialing. Caffeine (in milligrams) and ethanol (in grams) intake were calculated from a semiquantitative food-frequency questionnaire. Mean daily caffeine intake in patients was 138.4 versus 246.6 mg in controls; medians were 101.1 versus 175.5 mg (P < 0.001). Mean daily ethanol intake in patients was 8.2 versus 6.2 gm in controls; medians were 2.4 versus 1.9 gm (P = 0.89). Cases drank less coffee than controls, but drank similar amounts of tea, soft drinks, fruit juices, and milk. Daily caffeine intake was not correlated with tremor severity or duration. ET patients consumed less caffeine than did controls, which is likely to be a dietary modification in response to tremor. The observation that caffeine consumption was not correlated with tremor severity raises the additional possibility that lower caffeine consumption in ET patients may not exclusively be a response to tremor. A prospective study is needed to explore whether decreased caffeine consumption is a risk factor for ET. © 2004 Movement Disorder Society [source] Factors related to lower urinary tract symptoms among a sample of employed women in Taipei,,§NEUROUROLOGY AND URODYNAMICS, Issue 1 2008Yuan-Mei Liao Abstract Aim To identify factors associated with lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. Methods This study is a cross-sectional, descriptive study. A total of 520 surveys were distributed to 26 elementary schools in Taipei. Logistic regression was used to identify possible factors related to individual LUTS. Results Study results were based on the information provided by 445 participants. Of the 445 teachers, 293 (65.8%) experienced at least one type of LUTS. Factors associated with urinary incontinence were body mass index (BMI), vaginal delivery, obstetric and/or gynecological surgery, bladder habits, and job control. Increased daytime urinary frequency was associated with chronic cough and chronic constipation. Bladder habits, straining to lift heavy objects at work and chronic constipation were associated with urgency. Nocturia was associated with age and caffeine consumption while intermittent stream was associated with the presence of a family history of LUTS and chronic constipation. Bladder habits and regular exercise were associated with weak urinary stream. Incomplete emptying was more likely to occur in teachers with chronic constipation and in those who did not exercise regularly. Conclusion All the LUTS under logistic regression analyses were associated with 1,3 modifiable factors. Identification of these modifiable contributing factors may be useful to health care providers. Education of women may include the importance of maintaining normal body weight, good bladder/bowel habits, and regular exercise, treating chronic cough, decreasing daily caffeine consumption, and implementing feasible environmental modifications in employment settings. Neurourol. Urodynam. © 2007 Wiley-Liss, Inc. [source] Maternal caffeine consumption and fetal death: a case,control study in UruguayPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2006Alicia Matijasevich Summary Matijasevich A, Barros FC, Santos IS, Yemini A. Maternal caffeine consumption and fetal death: a case,control study in Uruguay. Paediatric and Perinatal Epidemiology 2006; 20: 100,109. The objective of this study was to examine the association between caffeine intake during pregnancy and fetal mortality in Montevideo, the capital city of Uruguay, taking into account several potential confounding factors. A population-based case,control study was conducted between 1 August 2002 and 31 December 2003. A total of 382 cases and 792 controls were recruited. Cases consisted of women hospitalised with a medically confirmed diagnosis of spontaneous antepartum fetal death, in all maternity hospitals during the study period. Antepartum fetal death was defined as a fetal death in which the attending doctor certified that the death occurred prior to the onset of labour. Fetal deaths were included if they were of at least 20 weeks' gestational age or weighed >350 g. Controls were women who had a live, vigorous and term adequate-for-gestational-age newborn. Multiple gestations and fetuses/newborns with evident congenital malformations were excluded. Only a small proportion of the mothers (8.1% of the cases and 9.5% of the controls) did not consume caffeine during pregnancy. Among consumers, mate drinking was the most frequent source of caffeine in both cases and controls. After controlling for mother's and her partner's education, history of abortions and/or fetal deaths, vomiting/nausea during the first trimester of gestation and attendance for prenatal care, the category of mean caffeine intake of ,300 mg/day showed a significantly increased risk of fetal death (OR 2.33 [1.23; 4.41]) compared with no caffeine consumption during pregnancy. The study also found that less-educated women, mothers who did not attend for prenatal care and women with a history of abortions and fetal death were at an increased risk of fetal death. As mate drinking is highly consumed among pregnant women in Uruguay, the association found with fetal death makes it a preventable risk factor. [source] Sex differences in the hemodynamic responses to mental stress: Effect of caffeine consumptionPSYCHOPHYSIOLOGY, Issue 4 2006Noha H. Farag Abstract The effect of caffeine on stress responses was compared in 25 men and 22 women in a 2-week placebo-controlled, double-blind, randomized crossover trial. On each week, participants abstained from all dietary sources of caffeine before undergoing a 6-h laboratory protocol under placebo or caffeine exposure followed by a 30-min mental stressor with blood pressure (BP) and cardiovascular hemodynamic assessments. On the placebo session, men and women showed a significant BP increase to stress, although women had significant cardiac responses whereas men had vascular responses. Caffeine ingestion before stress caused both men and women to have enhanced hemodynamic responses to the stressor associated with an increase in cardiac index and a drop in the peripheral resistance index. Caffeine enhances the cardiovascular fight-or-flight response pattern to stress in men and women. [source] Prospective study of caffeine consumption and risk of Parkinson's disease in men and womenANNALS OF NEUROLOGY, Issue 1 2001Alberto Ascherio MD, DrPH Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in 2 ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every 2,4 years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23,0.78; p for trend < 0.001) for men in the top one-fifth of caffeine intake compared to those in the bottom one-fifth. An inverse association was also observed with consumption of coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend < 0.001), and tea (p for trend = 0.02) but not decaffeinated coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1,3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease. [source] Coffee consumption and risk of rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 11 2003Elizabeth W. Karlson Objective Recent reports have suggested an association between consumption of coffee or decaffeinated coffee and the risk of rheumatoid arthritis (RA), although data are sparse and somewhat inconsistent. Furthermore, existing studies measured dietary exposures and potential confounders only at baseline and did not consider possible changes in diet or lifestyle over the followup period. We studied whether coffee, decaffeinated coffee, total coffee, tea, or overall caffeine consumption was associated with the risk of RA, using the Nurses' Health Study, a longitudinal cohort study of 121,701 women. Methods Information on beverage consumption was assessed with a food frequency questionnaire (FFQ) that was completed every 4 years, from baseline in 1980 through 1998. Among the 83,124 women who completed the FFQ at baseline, the diagnosis of incident RA (between 1980 and 2000) was confirmed in 480 women by a connective tissue disease screening questionnaire and medical record review for American College of Rheumatology criteria. Relationships between intake of various beverages and the risk of RA were assessed in age-adjusted models and in multivariate Cox proportional hazards models including the cumulative average intake of each beverage during the followup period, adjusted for numerous potential confounders. In addition, for direct comparisons with prior reports, multivariate analyses were repeated using only baseline beverage information. Results We did not find a significant association between decaffeinated coffee consumption of ,4 cups/day (compared with no decaffeinated coffee consumption) and subsequent risk of incident RA, in either an adjusted multivariate model (relative risk [RR] 1.1, 95% confidence interval [95% CI] 0.5,2.2) or a multivariate model using only baseline reports of decaffeinated coffee consumption (RR 1.0, 95% CI 0.6,1.7). Similarly, there was no relationship between cumulative caffeinated coffee consumption and RA risk (RR 1.1, 95% CI 0.8,1.6 for ,4 cups per day versus none) or between tea consumption and RA risk (RR 1.1, 95% CI 0.7,1.8 for >3 cups/day versus none). Total coffee and total caffeine consumption were also not associated with the risk of RA. Conclusion In this large, prospective study, we find little evidence of an association between coffee, decaffeinated coffee, or tea consumption and the risk of RA among women. [source] Effect of caffeine consumption on efficacy of methotrexate in rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 2 2003Gideon Nesher MD No abstract is available for this article. [source] Lifestyle factors in people seeking infertility treatment , A reviewAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010Kirsty ANDERSON Background:, Clinical infertility is a prevalent problem with significant financial and psychosocial costs. Modifiable lifestyle factors exist that may affect a person's time to conception and their chance of having a healthy, live birth. However, no guideline delineates what preconception advice should be offered to people presenting for infertility treatment. Aim:, The aim of this article is to review the literature regarding modifiable lifestyle factors in people seeking infertility treatment. Results:, A person's time to pregnancy and their chance of having a healthy, live birth may be affected by factors such as weight, vitamin and iodine intake, alcohol and caffeine consumption, smoking, substance abuse, stress, environmental pollutants, vaccinations and oxidative stress. Conclusions:, Advice on modifiable lifestyle factors should be given to people presenting for infertility treatment to help them make positive changes that may improve their chances of pregnancy and delivering a healthy, live baby. Developing a guideline for this would be a prudent step towards helping clinicians to implement this aspect of preconception care. [source] Maternal caffeine consumption and risk of cardiovascular malformations,,BIRTH DEFECTS RESEARCH, Issue 7 2007Marilyn L. Browne Abstract BACKGROUND: The physiologic effects and common use of caffeine during pregnancy call for examination of maternal caffeine consumption and risk of birth defects. Epidemiologic studies have yielded mixed results, but such studies have grouped etiologically different defects and have not evaluated effect modification. METHODS: The large sample size and precise case classification of the National Birth Defects Prevention Study allowed us to examine caffeine consumption and specific cardiovascular malformation (CVM) case groups. We studied consumption of caffeinated coffee, tea, soda, and chocolate to estimate total caffeine intake and separately examined exposure to each caffeinated beverage. Smoking, alcohol, vasoactive medications, folic acid supplement use, and infant gender were evaluated for effect modification. Maternal interview reports for 4,196 CVM case infants overall and 3,957 control infants were analyzed. RESULTS: We did not identify any significant positive associations between maternal caffeine consumption and CVMs. For tetralogy of Fallot, nonsignificant elevations in risk were observed for moderate (but not high) caffeine intake overall and among nonsmokers (ORs of 1.3 to 1.5). Risk estimates for both smoking and consuming caffeine were less than the sum of the excess risks for each exposure. We observed an inverse trend between coffee intake and risk of atrial septal defect; however, this single significant pattern of association might have been a chance finding. CONCLUSIONS: Our study found no evidence for an appreciable teratogenic effect of caffeine with regard to CVMs. Birth Defects Research (Part A), 2007. © 2007 Wiley-Liss, Inc. [source] | ||||||||||