Screening for Celiac Disease Recommended During Pregnancy

Gut 2000;46:332-335

(Celiac.com 03/17/2000) In the latest issue of Gut, Italian researchers propose that celiac disease is more common than previously thought, and that pregnant women should be screened for celiac disease. They conclude that a screening could help women to avoid negative outcomes and miscarriages. Dr. L. Greco and his colleagues from the University of Naples Federico II screened blood samples from 845 pregnant women in an effort to determine the prevalence of celiac disease. They looked for elevated levels of endomysial antibodies against tissue transglutaminase to determine how many of them had celiac disease. Out of the 845, women 12 had celiac disease (1.4%), and only three of the 12 had been previously diagnosed and were not following a gluten-free diet. The other nine women underwent a small intestinal biopsy to confirm their diagnosis. Out of the 12 diagnosed women, seven had either a pre-term delivery, or their babies were smaller than normal. Out of the remaining five women, four had had at least one miscarriage. Three of the babies died.

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When following up with 11 of the women, eight had another pregnancy and seven of them had reached term at the time of publication. Out of the eight women, five followed a gluten-free diet, and six of their babies turned out healthy. According to the researchers: Coeliac disease is considerably more common than most of the diseases for which pregnant women are routinely screened. The authors conclude: Consideration should be given to screening for coeliac disease in pregnancy, because of the high incidence of avoidable outcomes and the chance of reversibility through consumption of a gluten-free diet.