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  • Jefferson Adams
    Jefferson Adams

    Do High Levels of Celiac Disease Antibodies Put Pregnant Women at Risk for Low Birth Weight Babies?

    Reviewed and edited by a celiac disease expert.
    Do High Levels of Celiac Disease Antibodies Put Pregnant Women at Risk for Low Birth Weight Babies? - Photo: CC--Evil Erin
    Caption: Photo: CC--Evil Erin

    Celiac.com 06/12/2013 - Pregnant women with higher levels of issue transglutaminase (anti-tTG), an antibody common in people with celiac disease, at risk for low fetal and birth weight in their babies, according to a new study in Gastroenterology.

    Photo: CC--Evil ErinA number of studies before this one have confirmed an association between celiac disease and poor growth fetus growth, but very little study had been done as to how the level of celiac disease might affect fetal growth, birth weight or birth outcome.



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    In an effort to better understand how the level of celiac disease affects fetal growth, birth weight, and birth outcome, a team of researchers set out to assess the associations between levels of antibodies against tissue transglutaminase (anti-tTG, a celiac disease marker) and fetal growth and birth outcomes for pregnant women.

    The research team included J.C. Kiefte-de Jong, V.W. Jaddoe, A.G. Uitterlinden, E. A. Steegers, S.P. Willemsen, A. Hofman, H.Hooijkaas, and H.A. Moll of the Generation R Study Group at Erasmus University Medical Center in Rotterdam, The Netherlands.

    They conducted a population-based prospective birth cohort study of 7046 pregnant women. Serum samples were collected during the second trimester of pregnancy and analyzed for levels of anti-tTG.

    Based on these levels, they grouped each woman into groups of negative anti-tTG (≤0.79 U/mL; n = 6702), intermediate anti-tTG (0.8 to ≤6 U/mL; n = 308), or high anti-tTG individuals (over 6 U/mL; n = 36). They then collected data for fetal growth and birth outcomes from ultrasound measurements and medical records.

    The fetal growth data showed that, on average, fetuses of women in the positive anti-tTG group were 16 g lighter than those of women in the negative anti-tTG group (95% confidence interval [CI], -32 to -1 g) during the second trimester and weighed 74 g less (95% CI, -140 to -8 g) during the third trimester.

    The birth outcome data revealed that newborns of women in the intermediate and positive anti-tTG groups weighed 53 g (95% CI, -106 to -1 g) and 159 g (95% CI, -316 to -1 g) less at birth, respectively, than those of women in the negative anti-tTG group. Of mothers in the intermediate anti-tTG group, those with HLA-DQ2 or -DQ8 had reduced birth weights that were double those of mothers without HLA-DQ2 or -DQ8.

    This study led the researchers to conclude that levels of anti-tTG in pregnant women are inversely associated with fetal growth. The higher the anti-tTG in women, the lower the birth weights of their babies. So, women with the highest levels of anti-tTG (over 6 U/mL) saw the greatest reduction in birth weight of their babies.

    Also, women with intermediate levels of anti-tTG (0.8 to ≤6 U/mL) saw lower birth weights that were even further reduced if they carried the HLA-DQ2 and -DQ8 gene markers.

    Source:



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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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  • Related Articles

    Jefferson Adams
    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.
    So, 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.
    Source:
    Am J Gastroenterol. 2014;109:1653-1661.


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