The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #74122

Marilyn Browne, MS¹, Charlotte Druschel, MD¹, Allen Mitchell, MD², Paul Romitti, PhD³, Angela Lin, MD⁴, and Adolfo Correa, MD, PhD⁵. (1) Bureau of Environmental & Occupational Epidemiology, New York State Department of Health, 547 River Street, Room 200, Troy, NY 12180, 518 402-7990, mlb10@health.state.ny.us, (2) Boston University School of Public Health, Slone Epidemiology Center, 1010 Commonwealth Avenue, Boston, MA 02215, (3) Department of Epidemiology, University of Iowa, C21-E GH, 200 Hawkins Drive, Iowa City, IA 52242, (4) Genetics and Teratology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, (5) National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333

There is evidence from animal studies that maternal exposure to caffeine may cause cardiovascular malformations (CVMs) and other birth defects at high doses, and may enhance the teratogenicity of other substances such as nicotine, alcohol, bronchodilators, and phenytoin, at lower doses. However, most epidemiologic studies have failed to show a positive association between maternal caffeine use and risk of CVMs. It is possible that any increase in risk occurs mainly in interaction with other factors and only for certain types of CVMs. Since caffeine consumption in pregnancy is common, even a small increase in the risk of malformations would be an important public health concern. Using data from the NBDPS, we will examine whether maternal caffeine consumption during the first trimester increases the risk of CVMs, and whether caffeine acts as a “co-teratogen” in combination with alcohol, smoking, cocaine, or certain medications. Approximately 3300 CVM case-infants and 2500 control-infants will be included in the analysis. The number of CVM case-infants in the NBDPS is much larger than in most other epidemiologic studies to date, providing power to detect relatively small increases in risk of malformations. The number of CVM case-infants available for study will also permit analysis of mechanistically similar subgroups of CVMs. The results of our analysis of the association between caffeine intake and risk of CVMs will be presented.

Learning Objectives:

• At the conclusion of the presentation, participants will be informed of findings regarding caffeine consumption and cardiovascular malformations in the NBDPS.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.