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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
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
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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