Study: Energy Drinks Before Pregnancy Associated With Risk of Gestational Hypertension

Consuming energy drinks before pregnancy has been associated with an elevated risk of gestational hypertension, according to a study published in JAMA Network Open. Investigators noted that due to a low prevalence of intake and low consumption levels of those in the study, the results should be cautiously interpreted.

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According to the study authors, acute consumption of energy drinks has been associated with increased systolic and diastolic blood pressure, mental health symptoms including stress, anxiety, and depression, and caffeine-related complications including insomnia, headache, and irritation. Investigators aimed to determine the potential association between energy drinks before and during pregnancy and adverse pregnancy outcomes.

The study investigators used data from the Growing Up Today Study (GUTS) and the Nurses’ Health Study 3 (NHS3). The GUTS study originally included 16,882 adolescents aged 9 to 14 years and expanded to 10,923 individuals aged 9 to 14. Questionnaires were administered at baseline and then every 1 to 3 years. Energy drinks were reported in 2011 and in a follow up in 2015, with reported pregnancies included in the 2019 questionnaire. Investigators included data from January 1, 2011, to June 1, 2019.

The NHS3 study included nurses with enrollment starting in 2010. Questionnaires were completed at enrollment, then again approximately every 6 months. Women who were pregnant were asked additional questions about the pregnancy with additional questionnaires sent between 20 and 25 weeks’ gestation and 8 weeks after the estimated due date, according to the study authors. As of September 2021, there were 35,555 female nurses who answered questions about energy drink intake. The study investigators included data from June 1, 2010, and September 27, 2021.

The study included 7304 pregnancies among 4736 individuals who had data on energy drink intake pre-pregnancy and 4559 pregnancies among 4559 individuals with data on during pregnancy, according to the study authors. Energy consumption was low at 14% in the GUTS study and 9% in the NHS3 study. The mean consumption was 0.5 servings per day and 0.2 servings per day, respectively.

In the GUTS study, the mean age was 25.7 years old with a pre-pregnancy mean body mass index (BMI) of 23.6. Of the pregnancies among those who consumed energy drinks, 19% had spontaneous loss, 4% were pre-term delivery, 4% had gestational diabetes, 7% had hypertensive disorders, and 31% had at least 1 adverse pregnancy outcome, according to the results of the study. Of those with hypertensive disorders, 4% had hypertension and 3% had preeclampsia. The median time between the assessments including energy drink consumption and pregnancy occurrence was 22 months, according to the study authors.

In the NHS3 study, the mean age was 30.2 years old with a mean pre-pregnancy BMI of 24.7. In this study, the frequency of adverse pregnancy outcomes was 18% for spontaneous pregnancy loss, 4% for pre-term delivery, 5% for gestational diabetes, 5% for gestational hypertension, 3% for preeclampsia, 8% for hypertensive disorders, and 33% for any adverse pregnancy outcome, according to the study. The mean time between energy drink assessment and pregnancy was approximately 25 months, according to the study authors.

In the NHS3 study, there was a higher pre-pregnancy intake of energy drinks associated with a higher risk of gestational hypertension, according to the results. There was no association in the GUTS study. In the pooled analyses, energy drink consumption was only associated with gestational hypertension, according to the study investigators. Further, the association was stronger for older individuals. They did not find any association of consumption during pregnancy with any adverse pregnancy outcome.

Investigators said the implications of this study should be evaluated in future studies.

Reference

Ding M, Markon AO, Jones-Dominic OE, Purdue-Smithe AC, et al. Intake of Energy Drinks Before and During Pregnancy and Adverse Pregnancy Outcomes. JAMA Netw Open. 2023;6(11):e2344023. doi:10.1001/jamanetworkopen.2023.44023