Coffee is pretty great. Without our favorite form of caffeinated bean water, it’s entirely possible that society as we know it would collapse. There’s been a lot of focus on the attendant health benefits or risks of consuming coffee lately, especially after a recent analysis of 95 studies showed drinking up to five cups a day could be just fine. 

However, a new meta-analysis of the association between caffeine consumption and pregnancy complications suggests that expectant mothers might want to scale back their coffee consumption a bit. Published in the journal BMJ Evidence Based Medicine, researchers at Iceland’s Reykjavik University parsed data from 37 studies and 11 scholarly articles covering the impact of caffeine on pregnancies. At a broad level, their analysis found that maternal caffeine consumption is “reliably associated with major negative pregnancy outcomes.”

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Specifically, caffeine (regardless of source) was correlated with an observable increase in the risk of prenancy complications like miscarriage, stillbirth, or low birth weight. Eight of the studies reported a “significant association” between caffeine and miscarriage risk increase, while four of five observational studies examining caffeine and stillbirth observed increased risk, possibly up to five times over those who abstained from caffeine during pregnancy. Seven of ten low birth weight studies concluded caffeine consumption increased risks. Most importantly, the report found “no threshold of consumption below which associations are absent.”

These findings would seem to clash with existing recommendations from medical groups and public health organizations. For example, the American College of Obstetricians and Gynecologists states that consumption of up to 200 mg of caffeine a day (about two cups of coffee) “does not appear to be a major contributing factor in miscarriage or preterm birth.” The UK’s National Health Service similarly states that up to 200 mg is permissible. 

Of course, one shouldn’t feel pressured to cut out coffee entirely based on one meta-analysis that found correlations rather than direct causations. Still, it’s probably worth re-evaluating your four cup a day habit if you expect to be expecting in the near future. 

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