To examine whether maternal caffeine consumption is associated with the ris
k of spontaneous abortion, we analyzed data from a population-based prospec
tive study. The study population comprised 575 women delivering singleton l
ivebirths and 75 women who had spontaneous abortions. The subjects were pre
dominantly white, middle-class women enrolled before pregnancy. Study parti
cipants were traced to delivery of a liveborn, singleton infant or a sponta
neous abortion. Of the 71 women who did not experience nausea, 29.6% had a
spontaneous abortion, compared with 7.2% of 514 women who did experience na
usea. Maternal caffeine consumption before pregnancy, or in women without n
ausea, did not increase the risk of spontaneous abortion, whereas maternal
caffeine: consumption during the first trimester after nausea started might
increase risk of spontaneous abortion (risk ratio = 5.4, 95% confidence in
terval = 2.0-14.6 for caffeine consumption greater than or equal to 300 mg
per day compared with <20 mg per day). These results suggest that maternal
caffeine consumption during pregnancy may influence fetal viability in wome
n with nausea.