—Dr Wei is surprised that smoking and alcohol consumption were not strongly related to fetal loss in our study; however, this has also been observed in at least two previous studies.1,2 It is suggested that this could be because of a selection bias in our study. It seems unlikely that being a coffee drinker, a smoker, or an alcohol drinker would be related to day or night discharge. The analysis suggested for the odds of fetal loss before and during pregnancy is inadequate, since women did not necessarily shift in the lower intake category, and ours is a 3:1 matched analysis. Finally, we cannot see the appropriateness of controlling for caffeine intake during pregnancy when analyzing the effect of intake before pregnancy.Dr Kline and colleagues give a clear explanation of the results of their study in which cases were karyotyped. Although studying karyotypes is advantageous, it
Infante-Rivard C, Fernández A. Fetal Loss and Caffeine Intake-Reply. JAMA. 1994;272(1):28–29. doi:10.1001/jama.1994.03520010037018
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