• Dr Peter Chew

Is coffee dangerous in pregnancy?

Updated: Apr 16, 2019

G looked tense. Her face was creased with anxiety.

“Doc, I am a coffee addict. I can’t work without drinking three to four mugs of coffee a day. I am in my first trimester now and my friend told me that I may have premature birth if I continue drinking the beverage. Is it true?” She said apprehensively. "I am also in a dilemma. I will have terrible migraines when I stop drinking coffee. What should I do? "

Like G, many pregnant mums are in a quandary regarding the negative effects of coffee on their health as well as the developing foetus.

Coffee contains caffeine which is a well-known stimulant that can cause an increase in maternal blood pressure and heart rate. Caffeine can reduce iron absorption from food. It is also a diuretic that may induce loss of body fluid leading to dehydration. All these negative effects on health have led obstetricians to advise pregnant mum to reduce the consumption of coffee.

Caffeine has a negative influence on foetal growth too. Studies have shown that it can enter foetal circulation via the placenta. Its levels remain longer and higher in the foetus due to immaturity of the foetal liver which cannot break down caffeine as quickly as in the adult.

A number of animal studies have shown that caffeine can cause birth defects, premature labour, preterm delivery, and increase the risk of having low-birth weight offsprings.

However, no conclusive evidence has been found in the human.

Whether caffeine causes miscarriage remains controversial. In one study, women who consume 200mg or more of caffeine a day are twice as likely to have a miscarriage compared to those who do not drink coffee. In another study, no such increased risk has been found.

With regards to migraine, I told G that it was due to caffeine withdrawal. She should gradually wean herself off coffee, by sipping smaller amounts of the beverage slowly throughout the day. If the headache still persists and complete abstinence is not possible, a small cup of coffee with less than 200mg of caffeine a day is permissible. 

G tried to wean off coffee slowly by drinking decaffeinated coffee and tea. She succeeded in stopping drinking coffee after a few weeks. A healthy baby girl weighing 3 kg was delivered normally at term.

“Doc. Thanks for helping me kick the habit of drinking coffee,” she smiled as she told me during her postnatal visit.

“I also save a lot of money from buying expensive coffee,” quipped her husband.

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