Maternal Coffee Consumption During Pregnancy and Attention-Deficit/Hyperactivity Disorder in Offspring: A...

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Maternal diet can influence fetal neurodevelopment, and coffee is widely consumed during pregnancy and may have adverse effects on fetal development. This study aimed to investigate the association between maternal coffee consumption during pregnancy and ADHD risk in offspring.

First, we conducted a case-control study in Egypt, enrolling 176 mothers of children with ADHD and 504 mothers of typically developing children. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ADHD associated with frequent maternal coffee consumption during pregnancy. Then, we combined the results of this case-control study with those from prior studies in a meta-analysis. Between-study heterogeneity was assessed using the I² statistic, and publication bias was evaluated by Egger's regression test.

In the case-control study, frequent maternal coffee consumption during pregnancy was associated with a higher risk of ADHD in offspring (OR = 1.85; 95% CI: 1.17, 2.92). This association persisted after additional adjustments for antenatal, natal, and neonatal factors (OR = 1.82; 95% CI: 1.07, 3.09). Consistently, the meta-analysis showed a higher risk of ADHD associated with maternal coffee consumption during pregnancy (n = 7, OR = 1.33; 95% CI: 1.13, 1.57), with no between-study heterogeneity (I² = 8.89%, p = 0.36) or publication bias (z = 0.10, p = 0.92).

Both our case-control study and meta-analysis suggest that higher maternal coffee consumption during pregnancy may increase the risk of ADHD in children. Still, prospective cohort studies with objective caffeine biomarkers are needed to clarify causality and determine safe exposure levels.