Caffeine — Filtering the Facts

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Abstract
The article by Klebanoff and colleagues1 in this issue of the Journal adds to the growing body of literature examining the association of caffeine intake with adverse pregnancy outcomes and developmental problems. This study reports an association between spontaneous abortions, primarily in the second trimester, and unusually high levels of consumption of caffeine, equivalent to more than six cups of coffee a day.Unlike previous studies, in which exposure was estimated from the women's reports of the amount of caffeinated beverages they consumed, Klebanoff et al. used a biologic marker of caffeine intake, the levels of the caffeine metabolite paraxanthine . . .