The Artificial Sweeteners & Preterm Birth Debate

artificial sweetener pregnancy
Photo from Lyn. Click to read her blog.

An analysis of 59,334 women from the Danish National Birth Cohort (1996–2002) was done and published in the American Clinical Journal of Nutrition. Researchers looked at soft drink intake in midpregnancy by using a food-frequency questionnaire in order to determine if women who drank soft drinks that were artificially sweetened had a greater risk of preterm delivery than women who drank regular soft drinks.

They found an association between intake of artificially sweetened soft drinks and an increased risk of preterm delivery:

“In comparison with women with no intake of artificially sweetened carbonated soft drinks, the adjusted odds ratio for women who consumed ge 1 serving of artificially sweetened carbonated soft drinks/d was 1.38 (95% CI: 1.15, 1.65). The corresponding odds ratio for women who consumed ge 4 servings of artificially sweetened carbonated soft drinks/d was 1.78 (95% CI: 1.19, 2.66). The association was observed for normal-weight and overweight women. A stronger increase in risk was observed for early preterm and moderately preterm delivery than with late-preterm delivery. No association was observed for sugar-sweetened carbonated soft drinks (P for trend: 0.29) or for sugar-sweetened noncarbonated soft drinks (P for trend: 0.93).”

Of course, in fairness, the Aspartame makers commented on how this is really not a very valid study. (See why they think that here.) One of their big concerns is that the study used an odds ratio rather than a relative risk analysis in their results. That’s a good point. The aspartame makers feel it was because the numbers were just so low that that was the only way to show any impact. That was the only concern brought up that I felt was a valid enough reason to not mention what I found to you pregnant ladies in the Everything Birth Community. Then, I thought about it.

How big of a study do they want?  This was a huge sample of pregnant women.

I think they just worded it that way because they knew most people wouldn’t bother looking deeper and would conclude based on their argument that indeed, the actual numbers were too inconsequential to indicate any actual association.

59,334 soft drinking women were a part of this study.

Let’s look at where the women came from. These women were all of the ones that drank soft drinks in the larger Danish Cohort Study.

  • 101, 042 pregnant women and offspring were observed.
  • It incorporated about half of all Danish GPs.
  • It involved about 18% of all Danish pregnant women!

For me, if I were pregnant, I would consider this a large enough portion of a population to base a study on.

18% of all pregnant women would reflect trends.

Over half of them drank soft drinks. So about 1/10th of all of their society’s pregnant women were involved in the soft drink study.

So, just what were the preterm birth trends in their neck of the woods at that time?

In Denmark between 1995 and 2004 (which was the closest statistics that were explicit enough to use) the overall proportion of preterm deliveries out of all live births increased from 5.2% to 6.3%.

So, between 5 and 6 percent of live births are delivered before term over there.

The comments made by the Aspartame company about the choice in using odds ratios rather than relative risk was probably because of the extremely low number of preterm births is absurd in my opinion.  This is a huge sample. 1/10th of all pregnant women. I mean I get what they’re saying, but especially considering that there is another increase of risk of preterm birth demonstrated as these women increased their daily intake of artificially sweetened drinks, I think it’s something for us to think seriously about.

Is diet soda so awesome that it’s worth the risk the odds?


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