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Women in this group were far more likely to lose their babies (73 percent increased risk), and in women who had suffered a previous miscarriage, there was over a four-fold (400 percent) risk of spontaneous abortion associated with any intake of caffeine70 Action/Inaction In 1976, the Center for Science in the Public Interest (CSPI) sent a brief to the Department of Health urging the department to immediately inform doctors and pregnant women that caffeine may cause birth defects or miscarriages and that women in the first three months of pregnancy should minimize their consumption of caffeine. They cited new and compelling data reported in Medical World News that thirteen of fourteen women who drank seven or more cups of coffee per day had experienced problem pregnancies, including miscarriages and stillbirths.71 In 1981, the FDA issued an advisory warning that pregnant women should avoid caffeine-containing foods and drugs, if possible, or consume them only sparingly.72 But seventeen years later, this advice is still nearly impossible to follow

doi:10.1186/s12931-018-0867-z 93

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