A recent study performed by Dr. De-Kun Li, of The Kaiser Permanente Division of Research, examined maternal caffeine consumption during pregnancy and the risk of miscarriage. The study adds to the body of literature that shows an association between high levels of caffeine and miscarriage. In this study, the overall miscarriage rate was 18 percent. Miscarriage rate for non-caffeine drinkers was 12 percent.

Concerned? Heather Cook, from Alberta, Canada, is. "I am concerned, mostly because I'd been so unconcerned in the past," she says. "With my first pregnancy I didn't cut back on caffeine, but I didn't have more than a coffee or two a day. With my second, something really weird happened; I totally went off coffee. Couldn't stomach it. Of course, caffeine can be found in many things such as chocolate and drinks. If I were to get pregnant again, I'd be much more careful."

According to Dr. Tracy Flanagan, director of Women's Health, Kaiser Permanente, Northern California, this study stands out because of its careful design and its findings that a relatively low level of caffeine intake is associated with increased miscarriage. Based on the strength of this study, the March of Dimes recently announced that they are changing their caffeine advice recommendations.

"Based on the results of the study, I recommend that prenatal patients limit their daily intake of caffeinated beverages to less than 200 mg, especially during the first three months," Dr. Flanagan says. "For caffeinated beverages, this translates to 1 cup of coffee or 3 cups of tea or five sodas."

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