Family alcoholism may make going decaf tough Fri

NEW YORK (Reuters Health) - Women who are both hooked on caffeine and have a family history of alcoholism may have an especially tough time giving up their morning coffee during pregnancy, a small study has found.



The study of 44 pregnant women found that while most gave up or cut down on caffeine, those with both caffeine dependence and a family history of alcoholism were much less likely to be successful.

The findings, according to researchers, suggest that a genetic vulnerability toward addiction in general makes the caffeine habit hard to break for some.

Dr. Dace S. Svikis of Virginia Commonwealth University in Richmond led the study. The findings are published in the American Journal of Psychiatry.

Though studies have yielded conflicting results on the effects of caffeine use during pregnancy, some have linked it to an increased risk of miscarriage, impaired fetal growth and other complications. To be safe, health authorities in the U.S. and other countries advise pregnant women to abstain from caffeine or at least limit their intake.

But whether caffeine dependence is a substantial barrier for many women is unclear.

Caffeine dependence is not recognized as an official psychiatric diagnosis, as dependence on alcohol and other drugs is. Still, a number of studies have suggested it's a valid diagnosis, Svikis and her colleagues note.

Caffeine users have been found to show the classic signs of dependence -- including a need to have increasing amounts in order to feel the desired effect; withdrawal symptoms when they attempt to quit; and being unable to quit even though they want to.

In the current study, more than half of the women met the definition for caffeine dependence at some point in their lives. These women were less likely to be able to give up caffeine after learning they were pregnant -- despite the fact that all women in the study were advised by their doctors to cut out or at least cut down on caffeine.

But it was those women with both caffeine dependence and a family history of alcoholism who had the toughest time shunning caffeine.

During their first prenatal check-up, 14 percent of these women said they'd abstained from caffeine over the past week, versus 50 percent of women with neither caffeine dependence nor a family history of alcoholism. At the second prenatal visit, those figures were 21 percent and 63 percent, respectively.

Moreover, the researchers found, half of women with both caffeine dependence and alcoholism in the family continued to consume caffeine in excess of what's considered safe during pregnancy -- more than 300 milligrams per day, which is roughly equivalent to three cups of coffee.

Headache, fatigue, craving and difficulty getting through daily tasks were among the common reasons women cited for failing to cut back on caffeine.

Overall, Svikis and her colleagues write, the findings suggest that a "genetic vulnerability reflected in a family history of alcoholism may be necessary to express the problematic features of caffeine dependence."

Pregnant women who are both hooked on caffeine and have alcohol problems in the family, they conclude, may need stronger help from their doctors in cutting out caffeine