Celiac Disease Can Cause Pregnancy Problems

Threatened miscarriage, severe anemia common in women with celiac

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Celiac disease and pregnancy problems often are found together. Getty Images/Lester Lefkowitz

Women who have celiac disease suffer from pregnancy problems and complications at two to four times the rate of women who don't have the condition. It's possible, however, that following a careful gluten-free diet during pregnancy might help avert some of these problems.

Research shows that women with celiac disease have higher rates of infertility and miscarriage if they haven't been diagnosed.

But it appears that celiac disease-related pregnancy problems don't end there.

Research also indicates that women with celiac disease (mostly undiagnosed celiac disease) have higher rates of more than half a dozen pregnancy complications, including threatened miscarriage and severe iron deficiency anemia, than other women.

They also have shorter pregnancies, on average, and lower birth-weight babies.

Pregnancy Complications Affect Majority of Women with Celiac Disease

Pregnancy complications occur at a very high rate in women with celiac disease, according to a comprehensive Italian study of reproductive life disorders in celiac women. Some 65% of celiacs reported at least one gestational disorder, compared to 31% of women without celiac who served as controls for the study. According to that study:

  • Severe anemia occurred most commonly, affecting 41% of celiac women but only 2% of the control subjects.
  • "Threatened abortion," or threatened miscarriage, affected 39% of celiacs, but only 9% of the non-celiac controls.
  • Placental abruption, a dangerous condition in which the placenta that nourishes the unborn child begins to separate from the wall of the uterus, occurred in more than 18% of the celiac women but only 1% of controls.
  • Gestational hypertension, also known as pregnancy-induced hypertension, occurred in 10% of the celiac women and none of the control subjects.
  • Uterine hyperkinesia, or abnormal increased uterine muscle activity, also occurred in 10% of women with celiac disease and in none of the control subjects.
  • Intrauterine growth restriction, a condition in which the unborn baby fails to grow at the proper rate, occurred in more than 6% of celiac women but in none of the women serving as controls.

About 85% of the women in the study had not yet been diagnosed with celiac disease at the time of their pregnancies, and the authors speculated that following a gluten-free diet might avert pregnancy complications.

Celiac Women Also More Likely to Have C-Sections, Low Birth-Weight Babies

Additional research has shown links between celiac disease and other potential pregnancy problems.

For example, the incidence of low birth-weight babies seems to be almost six times higher in women with celiac disease than in other women.

Women with celiac disease tend to have shorter pregnancies—in the Italian study, a full two weeks shorter—which could be related to the incidence of low birth-weight babies.

And, cesarean sections also may occur more frequently in women with celiac disease, which could be significant due to newer research indicating children born by C-section may themselves have a higher risk of celiac disease down the road.

However, not all medical research has confirmed higher rates of these complications in women with celiac disease, and several studies have found little connection between celiac disease and pregnancy problems.

Most Celiac Disease-Related Pregnancy Problems Occur in Undiagnosed Women

Most of the celiac disease-related pregnancy problems seem to occur in women who have not yet been diagnosed with celiac, or in women who have been diagnosed but who are not following the gluten-free diet.

Like the Italian study, other studies have found similar high rates of pregnancy complications in women with undiagnosed celiac disease, and also have concluded that following a gluten-free diet may help them avert future problem pregnancies.

For example, a study from India compared women with a history of normal pregnancies with women who had a history of reproductive problems, including unexplained intrauterine growth restriction, and found a higher rate of positive celiac disease blood tests and latent celiac disease in the women reporting intrauterine growth restriction and other reproductive problems.

The researchers in that study concluded that physicians should consider screening women with unexplained pregnancy problems and other reproductive issues for celiac disease, since adhering to the gluten-free diet might help prevent future complications.

Should You Be Screened for Celiac If You've Had Pregnancy Problems?

Since many people who ultimately test positive for celiac disease show few classic signs of the condition, it's difficult to say whether you should be screened for celiac if you've had pregnancy problems.

Women who have been diagnosed with irritable bowel syndrome are more likely to have positive celiac disease tests, but they also occur in women without obvious gastrointestinal symptoms.

Ultimately, if you think undiagnosed celiac disease may be a possible cause for pregnancy problems you've had, especially if you have other celiac disease symptoms, talk to your doctor about having the celiac blood tests done.

Sources:

A. Kumar et al. Latent celiac disease in reproductive performance of women. Fertility and Sterility. Published online November 24, 2010.

D. Martinelli et al. Reproductive life disorders in Italian celiac women. A case-control study. BMC Gastroenterology. 2010 Aug 6;10:89.

L.J. Tata et al. Fertility and pregnancy-related events in women with celiac disease: A population-based cohort study. Gastroenterology. 2005 April, pp. 849-855.

National Institutes of Health. Celiac Disease and Reproductive Problems.

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