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No Higher Risk of Pregnancy Complications or Adverse Birth Outcomes in Women with Celiac Disease

Celiac.com 12/03/2014 - It is important for pregnant women seeking medical consultation to get good, evidence-based information. This is especially true for pregnant women with celiac disease, who might wonder whether they face an increased risk of adverse birth outcomes and pregnancy complications as a result of their disease.

Photo: CC--TrevorSo, does celiac disease increase a woman’s risk for pregnancy complications and adverse birth outcomes? Until now, there hasn’t been much good, solid data to give women a clear answer. With that in mind, a research team in England recently conducted a population-based study on pregnancy outcomes and adverse birth conditions in women with celiac disease.

The research team included Alyshah Abdul Sultan PhD, Laila J Tata PhD, Kate M. Fleming PhD, Colin J. Crooks PhD, Jonas F. Ludvigsson PhD, Nafeesa N. Dhalwani PhD, Lu Ban PhD, and Joe West PhD. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus at the University of Nottingham, Nottingham, UK; the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden; and with the Department of Paediatrics at Örebro University Hospital in Örebro, Sweden.

The team used linked primary care data from the Clinical Practice Research Datalink and secondary care Hospital Episode Statistics data to assess all singleton pregnancies between 1997 and 2012. They used logistic/multinomial regression to compare pregnancies of women with and without celiac disease for risks of pregnancy complications (antepartum and postpartum hemorrhage, pre-eclampsia, and mode of delivery), and for adverse birth outcomes (preterm birth, stillbirth, and low birth weight).

They stratified risk levels based on whether women were diagnosed or undiagnosed before delivery. They found 363,930 pregnancies resulting in a live birth or stillbirth, 892 (0.25%) of which were among women with celiac disease.

Women with diagnosed celiac disease showed no increased risk of pregnancy complications or adverse birth outcomes compared with women without celiac disease.

However, pregnant women with diagnosed celiac disease did show a higher risk of postpartum hemorrhage and assisted delivery, with an adjusted odds ratio (aOR) of 1.34.

Importantly, the team found no increased risk of any pregnancy complication among those with undiagnosed celiac disease.

In all, they found just a 1% absolute excess risk of preterm birth and low birth weight among mothers with undiagnosed celiac disease, which corresponds to aOR=1.24 (95% confidence interval (CI)=0.82–1.87) and aOR=1.36 (95% CI=0.83–2.24), respectively.

Overall, the results of this study offer some good news to pregnant women with celiac disease. Whether diagnosed or undiagnosed during pregnancy, celiac disease is not associated with a significantly higher risk of pregnancy complications and adverse birth outcomes.

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9 Responses:

 
Linda Ostrow
Rating: ratingfullratingfullratingemptyratingemptyratingempty Unrated
said this on
08 Dec 2014 3:50:18 PM PST
I beg to differ. Now granted, I had CD but I was undiagnosed. I took all of the pre-natal vitamins which included a healthy amount of folic acid but of course my body did not absorb the nutrients. My son was born with a unilateral cleft lip and palate. We put him through at least 18 surgeries. It is now suspected that clefts, like spina bifida, is caused by a lack of folic acid. Undiagnosed CD in pregnancy can be a major problem.

 
Jefferson
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said this on
13 Dec 2014 12:55:55 PM PST
You are describing one single birth, and one single case. The study looked at 363,930 pregnancies. That means they can get a clearer picture of the overall issue. The vast majority of pregnant women with celiac disease will not share your experience.

 
Nicole
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said this on
08 Dec 2014 7:08:47 PM PST
This is the worst article I have ever read. How can a woman with undiagnosed celiac disease be able to carry a baby to term? It's an autoimmune disease, malabsorption, etc.... Please do the research over because this is not a convincing study.

 
admin
( Author)
said this on
10 Dec 2014 4:06:55 PM PST
In most cases celiac disease doesn't prevent a woman from carrying a baby to term, but does increase the chances that they can't.

 
Helen
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said this on
04 May 2015 12:26:00 PM PST
You don't mention miscarriage? I suffered 6 miscarriages. I was otherwise healthy. In fact, there were a couple of physicians who refused to believe the facts. We even had genetic counseling. I was diagnosed CD at age 65.... if only I had known!

 
Laura
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said this on
10 Dec 2014 6:36:37 PM PST
Dangerous article. I now know I had undiagnosed celiac during both my pregnancies. Not surprisingly I had problems with low iron and blood cell counts. In the second I required an emergency C-section due to a placental abruption, which I have since read in other studies is an increased risk for Celiac pregnancies. Common sense should make anyone snort in derision at this "study." It's common knowledge that Celiac contributes to infertility. Of course it will contribute to increased pregnancy complication risks.

 
Jefferson
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said this on
13 Dec 2014 12:53:01 PM PST
You are one single person. The study looked at 363,930 pregnancies. The difference is crucial.

 
WendyKat
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said this on
15 Dec 2014 1:39:38 PM PST
Perhaps this was covered in the actual study itself and not the summary, but how did they determine the difference between undiagnosed celiac disease and those who do not have celiac disease? It kind of sounds like the "undiagnosed" sample group were just people who were diagnosed after the birth but before the study. Yet, we know that there is a high percentage of people who have celiac disease and don't know it. So - did they also test all of the women that they put in the 'no celiac disease' group to verify that they do, in fact, belong in that group and not in the 'undiagnosed' group? If not, then I'm not sure if this study is valid. What if many of those in the 'normal' group who HAD problems are undiagnosed celiacs and remain so? That would change the comparative statistics and possibly the conclusion of the study.

 
Lucille Cholerton
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said this on
24 Apr 2015 2:02:40 PM PST
I believe this study is flawed. I had three pregnancies 40 years ago. I was an un-diagnosed celiac. Pre-pregnancy I suffered from infertility. During my 1st pregnancy I suffered from on-going low folic acid and threatened miscarriages. I was very conscientious about taking the folic acid capsules. My first childbirth was fine, though breast-feeding was a problem as my son was always colicky. All three babies suffered from colic due to my eating gluten, and the gluten passing into the breast milk. My middle daughter was born jaundiced. The Pediatrician said this was a sign of "immature liver enzymes". She was lactose intolerant.




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