公衆衛生80巻9号

2016年09月発行

連載 ［講座］子どもを取り巻く環境と健康・19

妊娠中のカフェイン摂取の母児への影響

著者： 佐田文宏¹² 佐々木成子³ 岸玲子²

所属機関： ¹中央大学保健センター ²北海道大学環境健康科学研究教育センター ³北海道大学大学院医学研究科公衆衛生学分野

ページ範囲：P.701 - P.707

　カフェインは，嗜好品であるコーヒー，紅茶，緑茶，ココア，チョコレート，ソフトドリンク等に含まれ，経口的に摂取される．コーヒーの効用(効能)に関する情報が流布していることから，コーヒー(特に，含有するカフェイン)摂取は，健康によいと思いがちであるが，必ずしもそうではない．特に妊娠可能な若い女性には，流産や胎児発育遅延のリスクを高める可能性があるので注意を要する．妊娠中の女性は，日々の飲食中のカフェイン摂取量に関心を持ち，過度に摂取しないように心掛けることが必要と思われる．今後，カフェイン摂取に関連する遺伝的な体質と摂取制限に関する有効な方法を明らかにする研究がさらに進歩すれば，妊婦の栄養指導に，体質の把握とともにカフェイン摂取制限を含めることを考慮すべきと考えられる．

参考文献

1)Higdon JV, et al:Coffee and health:a review of recent human research. Crit Rev Food Sci Nutr 46(2):101-123, 2006

2)Peck JD, et al:A review of the epidemiologic evidence concerning the reproductive health effects of caffeine consumption:a 2000-2009 update. Food Chem Toxicol 48(10):2549-2576, 2010

3)Brent RL, et al:Evaluation of the reproductive and developmental risks of caffeine. Birth Defects Res B Dev Reprod Toxicol 92(2):152-187, 2011

4)Martin TR, et al:The association between low birth weight and caffeine consumption during pregnancy. Am J Epidemiol 126(5):813-821, 1987

5)Fortier I, et al:Relation of caffeine intake during pregnancy to intrauterine growth retardation and preterm birth. Am J Epidemiol 137(9):931-940, 1993

6)Committee on Toxicity:Statement on the reproductive effects of caffeine. London:Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment, 2008.　http://cot.food.gov.uk/cotstatements/cotstatementsyrs/cotstatements2008/cot200804

7)CARE Study Group:Maternal caffeine intake during pregnancy and risk of fetal growth restriction:a large prospective observational study. BMJ 337:a2332, 2008

8)Greenwood DC, et al:Caffeine intake during pregnancy and adverse birth outcomes:a systematic review and dose-response meta-analysis. Eur J Epidemiol 29(10):725-734, 2014

9)Chen LW, et al:Maternal caffeine intake during pregnancy is associated with risk of low birth weight:a systematic review and dose-response meta-analysis. BMC Med 12:174, 2014

10)Rhee J, et al:Maternal caffeine consumption during pregnancy and risk of low birth weight:A dose-response meta-analysis of observational studies. PLoS One 10(7):e0132334, 2015

11)佐田文宏，他：不育症に係わる遺伝要因，環境要因及びそれらの交互作用．産婦人科の実際60(10):1409-1422, 2011

12)Bech BH, et al:Coffee and fetal death:a cohort study with prospective data. Am J Epidemiol 162(10):983-990, 2005

13)Weng X, et al:Maternal caffeine consumption during pregnancy and the risk of miscarriage:a prospective cohort study. Am J Obstet Gynecol 198(3):279. e1-8, 2008

14)Greenwood DC, et al:Caffeine intake during pregnancy, late miscarriage and stillbirth. Eur J Epidemiol 25(4):275-280, 2010

15)Chen LW, et al:Maternal caffeine intake during pregnancy and risk of pregnancy loss:a categorical and dose-response meta-analysis of prospective studies. Public Health Nutr 19(7):1233-1244, 2016

16)Li J, et al:A meta-analysis of risk of pregnancy loss and caffeine and coffee consumption during pregnancy. Int J Gynaecol Obstet 130(2):116-122, 2015

17)Stefanidou EM, et al:Maternal caffeine consumption and sine causa recurrent miscarriage. Eur J Obstet Gynecol Reprod Biol 158(2):220-224, 2011

18)Zhang BY, et al:Risk factors for unexplained recurrent spontaneous abortion in a population from southern China. Int J Gynaecol Obstet 108(2):135-138, 2010

19)Landi MT, et al:Human cytochrome P4501A2. IARC Sci Publ 148:173-195, 1999

20)Signorello LB, et al:Caffeine metabolism and the risk of spontaneous abortion of normal karyotype fetuses. Obstet Gynecol 98(6):1059-1066, 2001

21)Sachse C, et al:Functional significance of a C→A polymorphism in intron 1 of the cytochrome P450 CYP1A2 gene tested with caffeine. Br J Clin Pharmacol 47(4):445-449, 1999

22)佐々木成子，他：妊婦のカフェイン摂取とCYP1A2遺伝子多型による出生時体格への影響．日本衛生学雑誌70(Supplement):S183, 2015

23)Sata F, et al:Caffeine intake, CYP1A2 polymorphism and the risk of recurrent pregnancy loss. Mol Hum Reprod 11(5):357-360, 2005

24)Jahanfar S, et al:Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcomes. Cochrane Database Syst Rev 6:CD006965, 2015

25)Cornelis MC, et al:Genome-wide meta-analysis identifies regions on 7p21(AHR)and 15q24(CYP1A2)as determinants of habitual caffeine consumption. PLoS Genet 7(4):e1002033, 2011

26)Sulem P, et al:Sequence variants at CYP1A1-CYP1A2 and AHR associate with coffee consumption. Hum Mol Genet 20(10):2071-2077, 2011

27)Coffee and Caffeine Genetics Consortium:Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. Mol Psychiatry 20(5):647-656, 2015