COFFEE CONSUMPTION AND INTRAUTERINE GROWTH-RETARDATION IN BRAZIL

Objective: To examine the association between coffee consumption in pr egnancy and foetal growth. Design: Retrospective unmatched case-contro l study. Setting: Maternidade de Campinas, Universidade Estadual de Ca mpinas, Pontificia Universidade Catolica de Campinas, Hospital Albert Sabin. Subjects: 356 mother/baby pairs who had interauterine growth re tardation (IUGR) and 356 mother/baby pairs who were appropriate for ge stational age (AGA). Interventions: Newborns were classified as being IUGR according to the Lubchenco classification. Gestational age of the newborns was evaluated by the Capurro method. Coffee consumption in p regnancy was assessed by a food frequency questionnaire. Coffee consum ption and a range of risk factors for IUGR were stratified and entered into a logistic regression model. The final results were expressed by the attributable risk percent (AR%). Results: More IUGR mothers (85.4 %) than AGA mothers (70.5%) ingested coffee in pregnancy (OR = 2.45; P < 0.001). The proportion of mothers who delivered IUGR babies increas ed as the average consumption of coffee increased (test for trend = 31 .76; P < 0.001). The tendency for heavy coffee drinkers to deliver IUG R babies remained after controlling for alcohol intake and cigarette s moking (P < 0.001). According to the logistic regression model and to the attributable risk percent (AR% = 28.0%), coffee consumption, (inde pendent of average coffee consumption) was an important preventable ca use of IUGR in this Brazilian population. Conclusions: We recommend mo deration in the consumption of coffee in pregnancy, since intrauterine growth retardation increases the risk of perinatal and neonatal morbi dity and mortality. Further large prospective studies evaluating the c ontent of caffeine in the coffee consumed by this population is advise d.