Document Detail

Methylxanthines during pregnancy and early postnatal life.
MedLine Citation:
PMID:  20859804     Owner:  NLM     Status:  MEDLINE    
World-wide, many fetuses and infants are exposed to methylxanthines via maternal consumption of coffee and other beverages containing these substances. Methylxanthines (caffeine, theophylline and aminophylline) are also commonly used as a medication for apnea of prematurity.The metabolism of methylxanthines is impaired in pregnant women, fetuses and neonates, leading to accumulating levels thereof. Methylxanthines readily passes the placenta barrier and enters all tissues and thus may affect the fetus/newborn at any time during pregnancy or postnatal life, given that the effector systems are mature.At clinically relevant doses, the major effector system for methylxanthines is adenosine receptors. Animal studies suggest that adenosine receptors in the cardiovascular, respiratory and immune system are developed at birth, but that cerebral adenosine receptors are not fully functional. Furthermore animal studies have shown protective positive effects of methylxanthines in situations of hypoxia/ischemia in neonates. Similarly, a positive long-term effect on lung function and CNS development was found in human preterm infants treated with high doses of caffeine for apneas. There is now evidence that the overall benefits from methylxanthine therapy for apnea of prematurity outweigh potential short-term risks.On the other hand it is important to note that experimental studies have indicated that long-term effects of caffeine during pregnancy and postnatally may include altered behavior and altered respiratory control in the offspring, although there is currently no human data to support this.Some epidemiology studies have reported negative effects on pregnancy and perinatal outcomes related to maternal ingestion of high doses of caffeine, but the results are inconclusive. The evidence base for adverse effects of caffeine in first third of pregnancy are stronger than for later parts of pregnancy and there is currently insufficient evidence to advise women to restrict caffeine intake after the first trimester.
Ulrika Adén
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Handbook of experimental pharmacology     Volume:  -     ISSN:  0171-2004     ISO Abbreviation:  Handb Exp Pharmacol     Publication Date:  2011  
Date Detail:
Created Date:  2010-09-22     Completed Date:  2011-01-03     Revised Date:  2011-04-12    
Medline Journal Info:
Nlm Unique ID:  7902231     Medline TA:  Handb Exp Pharmacol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  373-89     Citation Subset:  IM    
Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Caffeine / metabolism,  toxicity*
Fetus / drug effects*
Prenatal Exposure Delayed Effects
Receptors, GABA-A / physiology
Receptors, Purinergic P1 / physiology
Reg. No./Substance:
0/Receptors, GABA-A; 0/Receptors, Purinergic P1; 58-08-2/Caffeine

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