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

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.

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.

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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.

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Linda
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said this on
18 Jun 2013 6:31:19 PM PDT
An FYI for all women of child-bearing age. I had undiagnosed celiac disease while I was pregnant with my second child. He was born with a cleft lip and palate, which many experts feel is a result of a low level of folic acid.




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I wanted to collect some of the info on NCGI in one place so that visitors who test negative but may still have an issue with gluten can be directed there. I'll add to this post as I find new links, but feel free to add or contribute anything you think may be of use! Matt --- Useful links: An overview from Alessio Fasano, one of the world's leading researchers on celiac and gluten sensitivity: https://www.youtube.com/watch?v=VvfTV57iPUY A scholarly overview from celiac disease magazine: https://www.researchgate.net/profile/Knut_Lundin/publication/232528784_Non-celiac_Gluten_Sensitivity/links/09e415098bbe37c05b000000.pdf A good overview from a sceptical but fair perspective: https://sciencebasedmedicine.org/a-balanced-look-at-gluten-sensitivity/ Another overview: https://celiac.org/celiac-disease/understanding-celiac-disease-2/non-celiac-gluten-sensitivity-2/ University of Chicago's excellent celiac site's take: http://www.cureceliacdisease.org/category/faq-non-celiac-gluten-sensitivity/ A compelling account in the British Medical Journal from an NCGI patient: http://www.bmj.com/content/345/bmj.e7982 Here's some positive news about a potential new test: http://www.medicaldaily.com/non-celiac-gluten-insensitivity-blood-test-392850 NCGI in children: NCGI and auto immune study: https://www.ncbi.nlm.nih.gov/pubmed/26026392 Also consider: Fodmaps: http://www.kcl.ac.uk/lsm/research/divisions/dns/projects/fodmaps/faq.aspx This Monash study: http://fodmapmonash.blogspot.co.uk/2015/03/the-truth-behind-non-celiac-gluten.html suggested some who think they're reacting to gluten should actually be reducing fodmaps Sibo: http://www.webmd.boots.com/digestive-disorders/small-intestinal-bacteria-sibo

I was just diagnosed in March and I totally feel you. I'm having a hard enough time with determining which lip glosses are safe, let alone all my face products etc. I feel like this 'grey area' is the biggest annoyance with Celiac. So many foods/cosmetics I thought were safe after reading the ingredient list are actually not safe at all! One website says it's safe, one says its not. All these unfamiliar ingredients and even after googling term after term still so many grey areas!! I'm sure in time it gets easier and second nature and you learn by trial and error but holy this constant uncertainty is super annoying haha.

This place is great. Learning a lot. Honestly, I've known people with celiacs in the past, but it never occurred to me that that's what could be wrong with me. But the more I learn, the more it fits. One more thought, the articles I'm reading seem to say that we need to avoid gluten meticulously. I'm certain that I didn't accidentally eat gluten, because I've basically only eaten meat and veggies. But, my family has continued eating as normal. My kids making pancakes and it getting in the air, toast with all the crumbs everywhere, etc. Could that exposure be enough to keep my blood antibodies high? Or does it need to be ingested?

Hey, I had Hashi's some 15 years prior to my celiac disease diagnosis. My doc put me on a very lose dose of Armour. It did bring down my antibodies (by half), but they were extremely high to begin with (anything over 30 was positive and mine initially were close to 4,000). My nodules and enlargement stayed constant. Both actually went away since I have been gluten free! Like Gemini, I am on Armour for life! But that's okay. Just had my TPO checked yesterday, in fact, and now the number is 360. So, better, but that lab range is anything over 15 is positive. No reappearance of the nodules or enlargement. I am also on a low carb high fat diet to treat my diabetes too.

Yes! Call University of Chicago! Switching you from one medication that's not working to another and back again isn't helping you. It's definitely time to look at something else. I'm so sorry that you're not feeling better.