PM2010: Association Between Prenatal Caffeine Exposure Measured in Meconium and Characteristics of Attention and Impulsivity in Childhood Using Conners Continuous Performance Test

Background: Despite the common use of caffeine during pregnancy, our understanding of how childhood neurocognitive development is affected by prenatal caffeine exposure is limited. This study utilized caffeine levels measured in meconium, reflective of cumulative in utero exposure, to determine whether this exposure relates to childhood attention and impulsivity related problems as captured by the commonly used neuropsychologic test, the Conners Continuous Performance Test 3rd Edition (CCPT-3).

Methods: Meconium samples of newborns within the longitudinal GESTation and the Environment (GESTE) cohort in Sherbrooke, Quebec, Canada, were collected after delivery and analyzed for contaminant concentrations, with caffeine being detected and quantified in all samples. At ages 8-11 years, children returned for a follow-up visit where they completed the computerized CCPT-3, assessing attention and impulsivity related problems through performance in four areas: inattention, impulsivity, sustained attention, and vigilance. Covariate data were collected via parental questionnaires administered during and after pregnancy. Adjusted linear regression models were used to assess associations between High/Low prenatal caffeine exposure dichotomized at the median meconium caffeine concentration and child performance across the four areas measured by the CCPT-3. Covariates included sociodemographic variables, maternal ADHD diagnosis, and gestational age, with missing data being imputed using multiple imputations.

Results: The final sample size was 150 children, categorized into High or Low prenatal caffeine exposure groups dichotomized at the median meconium caffeine concentration (376.27 ng g−1, IQR [169.12, 926.85]). A total of 26 (17%) of these children had been diagnosed with ADHD by their 8-11 year follow-up visit. No statistical differences between the population characteristics of the High and Low groups were found. Significant positive relationships were found between prenatal caffeine exposure and CCPT-3 inattention score (β=16, 95% CI [0.94, 30], p=0.03) as well as impulsivity score (β=7.3, 95% CI [1.8, 13], p=0.01), but not with sustained attention score (β= -1.0, 95% CI [-5.1, 3.1], p=0.64) or vigilance score (β= 0.35, 95% CI [-3.0, 3.7], p=0.83) (Figure 1). No differences were observed when stratified by child sex.

Conclusion: Higher prenatal caffeine exposure levels were associated with higher inattention and impulsivity scores on the CCPT-3 in school aged children. Future studies analyzing prenatal caffeine exposure may provide guidance regarding its dose effects.