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Mothers with Untreated Celiac Disease Face a Higher Risk of Underweight and Early-term Births; No Risk for Moms on Gluten-free Diet

Celiac.com 01/25/20010 - Women with celiac disease face greater risks for adverse pregnancy outcomes. A team of researchers recently set out to examine the effects of treated and untreated maternal celiac disease on infant birthweight and preterm birth. Among their findings are that expectant mothers with celiac disease face a higher risk of underweight and early-term birth than those without celiac disease.

The research team included A.S. Khashan, T.B. Henriksen, P.B. Mortensen, R. McNamee, F.P. McCarthy, M.G. Pedersen and L.C. Kenny. They are affiliated variously with the Anu Research Centre of the Department of Obstetrics and Gynecology at the University College Cork at Cork University Maternity Hospital in Ireland, the Perinatal Epidemiology Research Unit in the Department of Paediatrics at Aarhus University Hospital, the National Centre for Register-based Research at the University of Aarhus, Denmark, and the Biostatistics Group, University of Manchester, Manchester, UK.

For their data, they used a population-based cohort study of all live births in Denmark between 1 January 1979 and 31 December 2004. During that period, 836,241 mothers gave birth to a total of 1,504,342 babies. Mothers with diagnosed celiac disease gave birth to 1105 of those babies, while 346 were born to women with undiagnosed celiac disease.

The team considered mothers with diagnosed celiac disease to be following a gluten free diet, and those with undiagnosed celiac disease to be on a gluten-inclusive diet. The team measured outcomes based on birthweight, small for gestational age (SGA: birthweight <10th centile), very small for gestational age (VSGA: birthweight <5th centile) and preterm birth. They then compared the results for the treated and untreated celiac disease mothers with those of a celiac-free reference group.

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The research team found that mothers with untreated celiac disease gave birth to smaller babies [difference = –98 g (95% CI: –130, –67)], with a higher risk of SGA [OR = 1.31 (95% CI: 1.06, 1.63)], VSGA [OR = 1.54 (95% CI: 1.17, 2.03)] and early birth [OR = 1.33 (95% CI: 1.02, 1.72)] compared with women with no celiac disease.

The good news is that mothers with treated celiac disease showed no increased risk of reduced mean birthweight, or of delivering SGA and VSGA infants or preterm birth compared with mothers with no celiac disease.

From the results, the research team concluded that untreated maternal celiac disease increases the risk of low birthweight, SGA and VSGA, and preterm birth.

Diagnosis and treatment of maternal celiac disease with a gluten-free diet seems to return the birthweight and preterm birth rate to one comparable to women without celiac disease.

This study drives home the importance of expectant mothers with celiac disease maintaining a gluten-free diet to promote a healthy delivery.

Source: Human Reproduction, doi:10.1093/humrep/dep409

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3 Responses:

 
Erin
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said this on
25 Jan 2010 8:59:53 AM PDT
I had 4 pregnancies (3 live births) before I knew my Celiac was Celiac.

This article describes my pregnancies to a T.

My eldest was induced at 38 weeks due to IUGR. He weighed 4lbs 12ozs.

My 2nd came on his own at 35 weeks weighing 5lbs even.

My 3rd was an emergency section at 34 weeks as her heart was all over the place due to my health. Her weight was 4lbs 7ozs.

I am done having children but can't help but wonder how things would have been if I was healthy.

 
Sandra Barwick
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said this on
01 Feb 2010 2:12:26 AM PDT
Untreated celiacs are low in vitamin D because of malabsorption. (unless they sunbathe a great deal). This research ties perfectly with very recent good research showing much poorer birth outcomes for pregnant women with low vitamin D. Pregnant women should be screened for vitamin D and for celiac disease - esp given the recent research showing celiacs at three times the risk of having an autistic child, which may well stem (this is only a hypothesis presently, but an increasingly compelling one) from low vitamin D in the womb too. See the Vitamin D Council's website for more. I have an ASD child, undiagnosed celiac sensitivity (at least) in pregnancy, child was one month premature. Undiagnosed celiacs lack so many nutrients, it may have even greater impact on an embryo.

 
Nicole
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said this on
01 Feb 2010 10:01:16 AM PDT
My first son was born at 28 weeks, only weighed 2 lbs. 2 1/2 years later I was diagnosed with celiac disease. My second pregnancy, I was gluten-free the entire time and had no complications (except for all the worry). There should be more awareness of the relation of celiac disease to Preterm/low birth weight.




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Hi Allie and welcome First off, I know 3 years was a long wait, but at 17 you've figured out celiac way before many people do. That should make a big impact on minimising its effects and helping you with the diet, so, bizarrely enough, congratulations! A lot of good advice has been brought together in this thread: Don't worry that your symptoms are bad now. As you follow the diet your body will begin healing itself and you're still very young so hopefully this will go really smoothly. Think in terms of the next 6 months rather than weeks however, recovery will likely take a little time. Eat as healthily as you can, lots of whole foods and try to avoid the gluten free processed substitutes as your digestive system needs all the help it can get at this moment. You may want to avoid dairy as well for now and think about reintroducing it later. This site has been really helpful to me and others. I hope you find it just as useful. Best of luck! ps, your increased reaction to gluten during the challenge phase was perfectly normal. Many find that reintroducing it much worse than the initial affects and take some time to get over the challenge. That's why you'll see lots of posts here urging folks to 'stay on gluten' till their testing is complete!

Hi! My daughter is 19 was diagnosed at age 16. It took about 12-18 month s for her to fully heal from the damage and feel "normal" again. Also because of the damage done she had reactions to dairy, so you may want to try no or minimum dairy until youre fully healed. Just a suggestion. Hope you start feeling well soon!

Hi yall! New to this blog, but really glad it exists because I have lots of questions. First off, I'm Allie! I'm 17 and newly diagnosed Celiac after about 3 years of searching for answers. I initially went gluten-free on the recommendation of a friend, I felt better in about a month and then my pediatric gastroenterologist had me do the gluten challenge, and my symptoms were the worst they have ever been, and ones I barely noticed before became very present. I did the biopsy and was diagnosed, it's been about 2 weeks and my symptoms are still pretty bad, although my diet has no known sources of gluten or cross contamination. Wondering if anyone has any input on healing post gluten challenge, any tips or how long it took for you would be quite helpful! Thanks

Might want to look into a keto diet, I have UC on top of celiacs and keto is working great Yeah I have major nerve and brain issues with gluten, gluten ataxia with nerve issues and brain issues. Seems to cause my body to attack my brain and nerve system. My brain stumbles fogs, and starts looping, the confusion causes me to become really irritable, I call it going Mr Hyde. Like my mind will start looping constantly on thoughts and not move driving me literally mad, or it used to. Now days it is primary the numbness anger but the gut issues and sometimes random motor loss limit me motionless to the floor now days for the duration of the major anger effects. Used to be a lot more mental then painful gut. I did a mental trauma post on it on while back where I came out about all my mental issues with gluten.

^^^^^^ good info, tips and tricks^^^^^^^^^ yes, crumbs will make you sick. also, breathing flour/pancake mix, etc that is in the air because eventually, you're going to swallow some.