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Celiac Disease And Pregnancy

Posted by jebby, 19 January 2013 · 3,469 views

Although I am pretty sure that I had Celiac Disease for more than two decades before my diagnosis, I was not diagnosed until after my 3rd child was born. Looking back, my diet during my first 3 pregnancies was a gluten-filled nightmare. I am actually glad that I have no idea how sky-high my celiac antibodies probably were while I was pregnant with my oldest kids.

There has not been a ton of research on celiac disease and pregnancy, but based on the work that has been done, I have learned that celiac disease has effects on fertility, miscarriage rates, fetal growth, and the ability to carry a pregnancy to term.

Celiac disease is associated with early menopause, endometriosis, irregular menstrual cycles, and amenorrhea (missed periods), similar to what is seen in many other autoimmune diseases.

Between 4 to 8% of unexplained infertility is due to undiagnosed celiac disease. Many celiacs with infertility as their main problem do not have the “classic” digestive symptoms that would normally lead to diagnosis.

Once pregnant, women with undiagnosed celiac disease have between a 2-4x higher risk of miscarriage than women who do not.

During pregnancy, women with untreated celiac disease are at a higher risk of anemia, preterm labor, stillbirth, and having infants with low birth weights (growth restriction). These problems are related to a combination of maternal nutrient deficiencies during pregnancy, as well as effects from the attack of the placenta by maternal auto antibodies (TTG).

As a part of taking care of premature babies, it is important for me to review the medical and obstetric histories of my patients’ mothers. I have come across women more times than I can keep track of who, upon review of their medical records, may have celiac disease (some combination of irritable bowel syndrome, anemia, thyroid disease, depression, infertility, diabetes, and/or asthma). I have a friend who did a small research study during her fellowship in which she evaluated the mothers of low birth weight babies for celiac disease. Through her study, one mother was diagnosed with celiac disease. Similar research has recently been conducted in Italy, with results mirroring my friend’s.

Based on the information on the University of Chicago Celiac Disease Center website, once a woman is diagnosed with celiac disease and on a strict gluten free diet, fertility should return. Experts have recommended waiting between 6 months to 2 years once being gluten free before trying to conceive, in order to give the body time to heal. It is essential for celiacs to be on appropriate vitamin and mineral supplementation while pregnant.

It is assumed that pregnancy outcomes for women with treated celiac disease are similar to those of women without it. The only exception is that celiacs are still at a higher risk of miscarriage, even when we are gluten free during pregnancy. I have personally experienced this; back in 2011 I miscarried within days of bad “glutening” episode.

In summary, women with unexplained infertility should be screened for celiac disease. Once diagnosed, it is important to remain strictly gluten free and take a good gluten free prenatal vitamin while pregnant. One of the best resources to check the gluten status of a medication is at www.glutenfreedrugs.com. Last of all, try not to worry about the effects of celiac disease on your baby! Treated maternal celiac disease has no association with birth defects, heart problems, cerebral palsy, etc. However, if you are like me, you will worry about your baby throughout your entire pregnancy…this is a totally normal part of being a mom!

For additional reading on celiac disease and pregnancy, I recommend the following links:

1. The National Foundation for Celiac Awareness’ 2009 article “Pregnancy and Celiac Disease.”

2. “Celiac Disease: An underappreciated issue in women’s health” by Shah, S (2010).

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This is very interesting information! It's believed that my mother's celiac was triggered when she was five months' pregnant with me after having an emergency appendectomy. She became extremely anemic, and I was born with Rickets. My three siblings clocked in at over nine pounds, but I weighed only 7 pounds 7 oz. As a child and adult, I suffered from MANY symptoms of nutritional deficiency and miscarried three times. I did give birth to two healthy children. One has confirmed celiac, and I suspect the other one has it, too (but she refuses to be tested). This can definitely be a scary disease!
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Hi, Thank you for commenting...I am happy to know that someone is reading! I think that this is a big reminder that Celiac Disease is a multi-systemic autoimmune disease which effects much more than the GI tract. I am a mom of 4 and I am very closely watching all of my kids for symptoms. My mother was not diagnosed until after I was, and looking back, we can see signs and symptoms in many family members. I am trying to increase awareness because I find it so sad that there are so many women out there with unexplained infertility who may have untreated Celiac Disease.
Anyway, thank you and all the best to you!
Jess
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Thanks for the great information. I'm getting mixed feedback from doctors regarding pregnancy. I have just been diagnosed with Celiac (I'm 37). I have only had symptoms for 6 months and all my nutritional levels seem to be ok. However, I do have stomach damage. Both OBGYNs I consulted said that I should try to get pregnant immediately and that the longer I leave it, the more chronic the condition will become - resulting in more problems. However, I read here (and elsewhere) that it's ideal to let the stomach heal first (I presume so that you'll be able to absorb nutrients normally during pregnancy). Not sure what to do!

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Hi Josie,
I am sorry that I am just seeing this now. I think that you are getting differing advice because you fall into such a gray area of what to do. Although it makes sense to wait to heal, improve your bowel absorption, and rest (as I wrote about in this paper when I reviewed this topic), if you are 37, your fertility is rapidly dwindling. Although I cannot give true medical advice on here, if you were a friend of mine I would suggest trying for the baby! I hope that whatever you choose, that things go well for you!
J
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