She’s hypercaffeinated, and she’s planning to conceive!

Self-policing may be at work, too

It’s interesting that many pregnant women appear to “spontaneously” reduce their intake of caffeine from coffee as they advance through the first trimester. In a study of women at 4 weeks of pregnancy, median caffeine consumption was 350 mg/day; as the women advanced through the first trimester, median caffeine consumption decreased to approximately 200 mg/day.²

In addition, although 33% of women reported drinking coffee before they became pregnant, only 15% were still drinking coffee near the end of the first trimester.

Take pregnancy planning beyond caffeine, of course

For women who are planning a pregnancy in the near future, moderating caffeine consumption is just one, relatively small, aspect of a multifaceted strategy to best plan their pregnancy. When one of your patients tells you that she is preparing to become pregnant, keep in mind for discussion the broader list of key areas that you can tell her to focus on (TABLE 2).That list includes

• achieving BMI in the normal range
• ensuring adequate intake of folic acid
• updating immunizations as appropriate
• testing for HIV infection
• assessing the effects of current prescription medications on a pregnancy
• reducing alcohol intake
• stopping cigarette smoking and recreational psychoactive drugs.

Every pregnancy—and every child— is precious. Thoughtful preparation to enhance the outcome of pregnancy is an effort well spent.

To that end, “all things in moderation” remains a useful adage.

TABLE 2

“Avoidance” advice for women who want to optimize fertility and pregnancy outcome