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

    Jefferson Adams
    No Higher Risk of Pregnancy Complications or Adverse Birth Outcomes in Women with Celiac Disease
    Caption: Photo: CC--Trevor

    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.

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    Guest Linda Ostrow

    Posted

    I beg to differ. Now granted, I had celiac disease 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 celiac disease in pregnancy can be a major problem.

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    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.

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    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.

    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.

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    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.

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    Guest Jefferson

    Posted

    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.

    You are one single person. The study looked at 363,930 pregnancies. The difference is crucial.

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    Guest Jefferson

    Posted

    I beg to differ. Now granted, I had celiac disease 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 celiac disease in pregnancy can be a major problem.

    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.

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    Guest WendyKat

    Posted

    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.

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    Guest Lucille Cholerton

    Posted

    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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    Guest Helen

    Posted

    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.

    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 celiac disease at age 65.... if only I had known!

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    Guest Momma Jamma

    Posted

    I was diagnosed with celiac at age 62.  I believe now that I had 'silent celiac disease' since puberty.  I was always very thin, but not unhealthy looking.  From the age of 12, I could eat anything & everything and never gain an ounce, plus I was always hungry.  In school I ate as much as most male athletes & I mean big guys. Bread was my favorite food & I seemed to thrive on it.  At 5'1" & 97 pounds, no matter what I ate, I couldn't break 100 pounds until I got pregnant.  I just ate a lot to get the nutrients I needed to maintain my tiny frame.  I had always tried to gain weight.  I had no symptoms of celiac.  I was just hungry, so I ate.  With my first pregnancy, while practicing birth control, I gained over 30 pounds.  I was at 91 lbs at the time.  My baby was 1 day late & weighed in at 8# 2oz.  I had natural childbirth in 6 hours w/no complications.  My milk came in exactly on time & the only problem I had was continuing to make milk for a few weeks after weaning my child.

    My next pregnancy ended in miscarriage at about 2 1/2 months.  The doctors put me on diethylstilbestrol (sp?) which kept a dead baby inside me for about 6 weeks, at which time I went into labor.  That drug caused vaginal cancer in little girls when they reached puberty.  After that I was sick for a year & didn't even think I could conceive again.  I weighed 86 pounds, was pale, weak & had no energy, when I turned up pregnant again & yes, using birth control.  I had another easy pregnancy & delivered 5 days early, 8 pounds, 4 oz. healthy baby again via natural childbirth & a 2-hour labor.  My milk came in in 24 hours.  I breastfed this baby for over 2 years.  No excessive bleeding.  By the way, I gained 40 pounds & within 3 weeks after both deliveries, I was back to normal physically & my weight dropped to 97 pounds while eating everything in sight. I could be wrong, but it seemed like pregnancy made me healthier.

    My 'silent celiac' continued for 40 years & I was being treated for widespread pain, fibromyalgia.  I continued to worsen over 2 years & my rheumatologist tested me for celiac.  I was off the charts.  I also had Hashimotos, also without symptoms.  Still no celiac symptoms.  I have been totally gluten free 10 years, take a little thyroid pill, have osteopenia, am an 11-year breast cancer survivor,  @ 72 I still work, have finally gotten to a perfect weight of 115.  My blood pressure is 110 over 70.  I sleep like a baby & I am grateful.

     

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided 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 Dangerous Grains by James Braly, MD and Ron Hoggan, MA.

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