Women who drink eight or more cups of coffee a day during preg-nancy could be doubling or even trebling the risk of losing their child compared to those who abstain, say researchers. Even four cups a day, regarded as a safe level, could increase the chance of stillbirth by as much as 80%, they say.

The research findings published today confirm an earlier anecdotal link between high doses of caffeine and baby death and evidence from studies involving monkeys but the results could also increase anxiety among pregnant women about the safety of common foods and drinks after they were told on Monday to avoid eating too much tuna.

Kirsten Wisborg, a specialist registrar at the Aarhus University Hospital in Denmark who led the study, said, "The risk of stillbirth increased with the number of cups of coffee a day during pregnancy.

"Compared to women who did not drink any coffee, women who drank four to seven cups had an 80% increased risk of stillbirth and women who drank eight or more cups a day a 300% increased risk."

The Danish study, which is published in the British Medical Journal, focused on more than 18,000 pregnant women and found that heavy coffee drinkers were also more likely to smoke, drink more alcohol, be single parents and have less education.

Even after adjusting for the effect of smoking during pregnancy, the association between coffee consumption and stillbirth was just as significant.

"The adjusted risk of stillbirth was lower among women who drank one to three cups per day, slightly increased among women who drank four to seven cups a day and more than doubled among women who drank eight or more cups of coffee per day," said the research team.

"These results seem to indicate a threshold effect around four to seven cups a day.

"There did not seem to be one single cause that could explain the increased risk of stillbirth among women with a high intake of coffee."

This latest warning of a risk to the health of unborn babies comes just days after pregnant women were warned to limit the amount of tuna they eat because of the small risk that mercury in the fish posed to unborn and breastfeeding babies' developing nervous systems.

Pregnant women have also been advised to avoid eating shark, swordfish and marlin.

The Food Standards Agency has been advising pregnant women to limit their caffeine intake to less than 300mg, four cups of coffee, a day, for the past two years after the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment linked it to low birth weight and miscarriage.

A limit of 300mg is the equivalent to six cups of tea, eight cans of regular cola drinks, four cans of caffeine-based energy drinks or eight 40g bars of chocolate.

A spokeswoman for the Food Standards Agency said, "Although we have just seen the paper, its findings seem to be broadly consistent with the body of evidence on the effects of caffeine on pregnant women which was reviewed by the Committee on Toxicity and led the FSA to advise pregnant women to limit their caffeine intake to 300mg or four cups of coffee a day.

"Unless a more extensive look at the research shows something different there doesn't seem to be any need to review our position."

A dietitian at the University Hospital of Wales in Cardiff, Jacqui Lowdon, said she and her colleagues would not be making any changes to their recommendations based on advice from the Royal College of Midwives and the Centre for Preg-nancy Nutrition, for a daily caffeine intake of not more than 300mg, as a result of the Danish study.

British Coffee Association spokesman Roger Cook said pregnant women should not be alarmed by the results of the latest study.

"The results of this study do not alter the advice given to pregnant women on caffeine consumption during pregnancy by the Food Standards Agency which states that 300mg caffeine, equivalent to three mugs or four cups of coffee per day, is perfectly safe and will have no adverse effect on the mother or the foetus," he said.

"Further, the Centre for Pregnancy Nutrition states that it is perfectly safe for a pregnant woman to drink up to four or five cups of coffee or tea a day while pregnant or breastfeeding."

Madeleine Brindley Madeleine.Brindley@Wme.Co.Uk, The Western Mail - The National Newspaper Of Wales, Feb. 21, 2003