Caffeine enzymes' activity linked to spontaneous abortion risk


NEW YORK (Reuters Health) – The activity level of two enzymes involved in caffeine metabolism are associated with the risk of spontaneous abortion, according to a report in the December issue of Obstetrics and Gynecology.

Caffeine exposure has been linked with an increased risk of normal karyotype abortions. However, it has been unclear how the activity of enzymes that metabolize caffeine might influence this risk.

Dr. Lisa B. Signorello, from the International Epidemiology Institute in Rockville, Maryland, and colleagues assessed the activity of two caffeine-related enzymes in 101 women who experienced normal karyotype abortions and in 953 women who were 6-to-12 weeks pregnant. Caffeine intake was also determined in both groups.

The researchers hypothesized that reduced activity of enzymes that break down caffeine would be associated with an increased risk of spontaneous abortion.

High activity of cytochrome P4501A2 (CYP1A2), caffeine's primary metabolic enzyme, was tied to a significantly increased risk of spontaneous abortion, Dr. Signorello's group reports. In contrast, low activity of another enzyme that metabolizes caffeine, N-acetyltransferase (NAT2), was associated with an increased risk of primary and recurrent spontaneous abortion, the authors note. Caffeine intake was only a risk factor for abortion in women with high CYP1A2 activity.

Contrary to the researchers' hypothesis, high CYP1A2 activity appears to increase abortion risk, independently and in association with caffeine. The NAT2 findings were weaker, but they suggest that low activity is linked to an elevated spontaneous abortion risk.

"Most of our analyses relied on small numbers, producing statistically imprecise estimates of relative risk that should be interpreted with caution," the authors note. "They do indicate, however, that further study of caffeine metabolism and normal karyotype spontaneous abortion is warranted."

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