Untreated Celiac Disease Linked To Poor Birth Outcomes

Am J Gastroenterol 1999;94:2435-2440.

(Celiac.com 04/10/2000) A study by Danish researchers that
was published in the September issue of the American Journal
of Gastroenterology concludes that treating women who have
celiac disease before they become pregnant improves their birth
outcomes. According to Dr. Bente Norgard and colleagues of the
University of Aarhus, Denmark, "Our study emphasizes the
importance of encouraging fertile women to maintain a
gluten-free diet once they have been diagnosed, because the
time of establishing the diagnosis and subsequent treatment
is the major predictor for a favorable birth outcome."

The Danish team examined the outcomes of 211 newborns from 127
women with celiac disease, and compared them to 1,260 births
to women without celiac disease, from data collected between
1977 and 1992 by the Danish Medical Birth Registry.  Their
results showed that birth outcomes were worse in women with
untreated celiac disease than in women who had been
hospitalized for celiac disease, and that the risk of low
birth weight and intrauterine growth retardation were
increased 2.6 and 3.4 fold respectively when compared to the
infants born to women with celiac disease and no prior
hospitalization for the disease. These same risks were not
increased in women with celiac disease who had prior
hospitalization for it.

According to Dr. Norgard, "Our results emphasize the
importance of clinical awareness of this chronic disease."
Their conclusion is that untreated celiac disease is a major
risk factor for poor birth outcomes, and that the treatment
of celiac disease in women is important in the prevention of
fetal growth retardation.



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 3
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.

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."

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