Preliminary indications that functional effects of fetal caffeine exposure can be expressed in a second generation

Perinatal caffeine, acting on maternal adenosine A(1) receptors, causes long-lasting behavioral changes in mouse offspring

BACKGROUND

There are lingering concerns about caffeine consumption during pregnancy or the early postnatal period, partly because there may be long-lasting behavioral changes after caffeine exposure early in life.

METHODOLOGY/PRINCIPAL FINDINGS

We show that pregnant wild type (WT) mice given modest doses of caffeine (0.3 g/l in drinking water) gave birth to offspring that as adults exhibited increased locomotor activity in an open field. The offspring also responded to cocaine challenge with greater locomotor activity than mice not perinatally exposed to caffeine. We performed the same behavioral experiments on mice heterozygous for adenosine A(1) receptor gene (A(1)RHz). In these mice signaling via adenosine A(1) receptors is reduced to about the same degree as after modest consumption of caffeine. A(1)RHz mice had a behavioral profile similar to WT mice perinatally exposed to caffeine. Furthermore, it appeared that the mother's genotype, not offspring's, was critical for behavioral changes in adult offspring. Thus, if the mother partially lacked A(1) receptors the offspring displayed more hyperactivity and responded more strongly to cocaine stimulation as adults than did mice of a WT mother, regardless of their genotype. This indicates that long-term behavioral alterations in the offspring result from the maternal effect of caffeine, and not a direct effect on fetus. WT offspring from WT mother but having a A(1)R Hz grandmother preserved higher locomotor response to cocaine.

CONCLUSIONS/SIGNIFICANCE

We suggest that perinatal caffeine, by acting on adenosine A(1) receptors in the mother, causes long-lasting behavioral changes in the offspring that even manifest themselves in the second generation.

Teratogen update: evaluation of the reproductive and developmental risks of caffeine

Caffeine is a methylated xanthine that acts as a mild central nervous system stimulant. It is present in many beverages, including coffee, tea, and colas, as well as chocolate. Caffeine constitutes 1-2% of roasted coffee beans, 3.5% of fresh tea leaves, and approximately 2% of mate leaves (Spiller, '84; Graham, '84a,b). Many over-the-counter medications, such as cold and allergy tablets, headache medicines, diuretics, and stimulants also contain caffeine, although they lead to relatively minimal intake (FDA, '86). In epidemiological studies, it is assumed that one cup of coffee contains < or =100 mg of caffeine, and soft drinks, such as colas, contain 10-50 mg of caffeine per 12-ounce serving. The per-capita consumption of caffeine from all sources is estimated to be about 3-7 mg/kg per day, or approximately 200 mg/day (Barone and Roberts, '96). Consumption of caffeinated beverages during pregnancy is quite common (Hill et al., '77) and is estimated to be approximately 144 mg/day, or 2.4 mg/kg for a 60-kg human (Morris and Weinstein, '81). However, pregnant women appear to consume slightly less than do other adults, approximately 1 mg/kg per day (Barone and Roberts, '96). This decrease may be interrelated with taste aversion (Hook, '76; Little, '82). The medical literature contains many varied references that appear to indicate that human adverse reproductive/developmental effects are produced by caffeine. If caffeine indeed causes such effects, the reproductive consequences could be very serious because caffeine-containing foods and beverages are consumed by most of the human populations of the world, and consumption in the United States is estimated to be 4.5-kg/person/year (Narod et al., '91). Therefore, the medical literature dealing with developmental and reproductive risks of caffeine was reviewed, and the biological plausibility of the epidemiological and animal findings, as well as the methods and conclusions of previous investigators, were evaluated. The epidemiological studies describe exposures of women to caffeine during pregnancy, as well as the occurrence of congenital malformations, fetal growth retardation, small-for-date babies, miscarriages (spontaneous abortions), behavioral effects, and maternal fertility problems that presumably resulted from the caffeine consumption. A few epidemiological studies were concerned with the genetic effects of preconception exposures to caffeine. Animal studies, conducted mostly in pregnant rats and mice, were designed to produce malformations. The objectives of the present review are to summarize the findings from the various clinical and animals studies, objectively discuss the merits and/or faults inherent in the studies and establish a global reproductive risk assessment for caffeine consumption in humans during pregnancy. It should be noted that evaluation of the developmental risks of caffeine based solely on epidemiological studies is difficult because the findings are inconsistent. Even more important, is the fact that caffeine users are subject to multiple confounding factors that make analyses difficult and prevent investigators from reaching definitive conclusions. For example, the caffeine content of foods and beverages can vary considerably, which can interfere with obtaining valid interpretations from many human studies. Isolated epidemiological studies dealing with the risk of abortion, without evaluating other developmental and reproductive effects, are the most difficult to interpret, because they present special problems that are sometimes ignored in epidemiological studies. The results of animal studies are probably most helpful in solving some of the dilemmas created by the epidemiological studies. An animal study reported in 1960 first focused our attention on the potential developmental effects of caffeine. However, the exposure reported by Nishimura and Nakai ('60) was an intraperitoneal dosage of 250 mg/kg in the mouse, an extremely high dosage that would result in a blood plasma level that could never be obtained from consuming caffeine containing products. More recent animal studies have demonstrated, that depending on the method of administration and species, the developmental NOEL in rodents is approximately 30 mg/kg per day, the teratogenic NOEL is 8,100 mg/kg per day, and the reproductive NOEL approximately 80-120 mg/kg per day. Lack of biological plausibility to support the concept that caffeine has been responsible for human malformations is another important part of this analysis. For example, no one has described the Caffeine "teratogenic syndrome," a cluster of malformations associated with caffeine ingestion. Proven human teratogens have an identifiable syndrome. The malformations described in the animal studies at very high doses fit the description of vascular disruptive types of malformations. (ABSTRACT TRUNCATED)

Can Prenatal Caffeine Exposure Affect Behavioral Inhibition?

Given the widespread use of caffeine and its potential nonoptimal effects during pregnancy, it is remarkable and distressing that almost nothing is known about the long-term effects of prenatal caffeine exposure in humans. Research on nonhumans reveals that prenatal caffeine exposure is associated with an enduring tendency toward a profile of fearfulness, hypoactivity, and exaggerated stress in uncertain situations. A similar pattern of behavioral inhibition has been observed in humans and has been attributed to various causes such as inborn temperament or environmental influences. The author's conjecture is that prenatal caffeine exposure could be an additional factor contributing to the tendency toward behavioral inhibition. One mechanism for this effect is that caffeine causes an upregulation of adenosine receptors, thus creating a vulnerability to adenosine-induced inhibition of neuronal firing and neurotransmitter release.

Potential teratogenic and neurodevelopmental consequences of coffee and caffeine exposure: a review on human and animal data

The teratogenic effect of caffeine has been clearly demonstrated in rodents. The sensitivity of different animals species is variable. Malformations have been demonstrated in mice at 50-75 mg/kg of caffeine, whereas the lowest dose usually needed to induce malformations is 80 mg/kg in rats. However, when caffeine is administered in fractioned amounts during the day, 330 mg/kg/day are necessary to reach teratogenicity in rats. In rodents, the most frequently observed malformations are those of the limbs and digits, ectrodactyly, craniofacial malformations (labial and palatal clefts) and delays in ossification of limbs, jaw and sternum. Nevertheless, even in rodents, caffeine can be considered as a weak teratogenic agent, given the quite large quantities of caffeine necessary to induce malformations and the small number of animals affected. In humans, caffeine does not present any teratogenic risk. The increased risk of the most common congenital malformations entailed by moderate consumption of caffeine is very slight. However, caffeine potentiates the teratogenic effect of other substances, such as tobacco, alcohol, and acts synergistically with ergotamine and propranolol to induce materno-fetal vasoconstrictions leading to malformations induced by ischemia. Therefore, even though caffeine does not seem to be harmful to the human fetus when intake is moderate and spread out over the day, some associations, especially with alcohol, tobacco, and vasoconstrictive or anti-migraine medications should be avoided. Maternal consumption of caffeine affects brain composition, especially in case of a low-protein diet and also seems to interfere with zinc fixation in brain. Maternal exposure to caffeine induces also long-term consequences on sleep, locomotion, learning abilities, emotivity, and anxiety in rat offspring, whereas in humans, more studies are needed to ascertain long-term behavioral effects of caffeine ingestion by pregnant mothers.

Consequences on the newborn of chronic maternal consumption of coffee during gestation and lactation: a review

The present review is devoted to effects on the newborn of maternal ingestion of caffeine during gestation and lactation. In rodents, caffeine is able to induce malformations, but usually at high doses never encountered in humans; indeed, when caffeine is administered in fractioned quantities during the day, as it is the case with human caffeine intake, caffeine is no longer a teratogen in rodents. Caffeine ingested during gestation induces a dose-dependent decrease in body weight, but only for large doses (> 7 cups/day of coffee), whereas it has no effect at moderate doses. Maternal caffeine consumption during gestation affects hematologic parameters in both rat and human infants and induces long-term effects on sleep, locomotion, learning abilities, emotivity and anxiety in rodent offspring, whereas in humans, more studies are needed to determine the consequences of early caffeine exposure on behavior. Investigators do not agree on the quantities of the methylxanthine found in breast milk, but caffeine does not change breast milk composition, and rather, stimulates milk production. We conclude in this review that maternal caffeine consumption in moderate amounts during gestation and lactation has no measurable consequences on the fetus and newborn infant. Pregnant mothers, however, should be advised to consume coffee and caffeinated beverages in moderation, especially because of the prolonged half-life of caffeine both during the last trimester of pregnancy and in the newborn infant.

Caffeine effects on meiotic maturation in hamster oocytes in vitro

The effect of caffeine on meiotic maturation in cultured hamster oocytes was investigated. Meiotic status was scored from chromatin spreads of oocytes previously exposed to caffeine (0, 0.00017, 0.0017, 0.017, 0.17, 1.7, 2.4, 5.1, and 10.2 mM) for up to 20 h. While concentrations of caffeine less than 0.017 mM failed to affect significantly the onset of meiotic resumption, 0.0017 mM caffeine significantly decreased the proportion of oocytes progressing normally to telophase I-metaphase II, and concomitantly increased the proportion of both diploid MII and aneuploid oocytes. In addition, 0.17 to 10.2 mM caffeine induced a dose-dependent increase in the proportion of meiotically arrested oocytes, with less than 5% oocytes progressing normally through to the final stages of meiotic maturation at 10.2 mM caffeine. Taken together, these data show that caffeine at concentrations as low as 0.0017 to 0.017 mM interfere with progression of meiotic maturation, and that concentrations higher than 0.017 mM delay initiation of this process. Since caffeine peaks at 0.017 mM in the plasma of women following a cup of brewed coffee, we conclude that caffeine-induced perturbations of oocyte meiotic maturation may be responsible, at least in part, for the recently revealed correlation between caffeine intake and reduced fertility in women.