CELIAC AND PREGNANCY

 

wp-1463048179000.jpgDifference between pregnancy-related events in coeliac versus non-coeliac populations

  • In a cohort study the proportion of births by caesarean section was almost 30% higher for women with coeliac disease than for the women in the comparison group. The study also showed miscarriages were slightly more common in women with coeliac disease (RR 1.31) and pregnancy experiences such as preeclampsia, postpartum haemorrhage, and still births to be similar between the two groups.
  • Also none of the women with coeliac disease had babies with neural tube defects, despite the concerns about folate deficiency in coeliac disease.
  • These results indicate that the risks of adverse pregnancy-related outcomes for women with coeliac disease are not as high as previously reported.

Dietary implications in pregnancy for coeliacs

  • There are no specific guidelines for pregnant women with coeliac disease. Standard nutritional advice during pregnancy is appropriate for women with coeliac disease and general guidelines are suitable, in particular advice to take folic acid supplements should be followed.
  • It is important that people with coeliac disease are followed up regularly, particularly at times of stress, i.e. pregnancy. Patients may experience deterioration in their symptoms and require additional support at this time. Depending on individual assessment and diet, supplementation with calcium, iron, and vitamin B12 may be required.

    References
    · Kolho KL et al. Screening for celiac disease in women with a history of recurrent miscarriage or infertility. British Journal of Obstetrics and Gynaecology 1999;106:171-173.
    · Norgard S et al. Birth outcomes of women with celiac disease; A nationwide historical cohort study. American Journal of Gastroenterology 1996;94:2435-2440.
    · Tata LJ et al. Fertility and pregnancy-related events in women with celiac disease: A population-based cohort study. Gastroenterology 2005;128:849-855.
    · Ciacci C et al. Coeliac disease and pregnancy outcome. American Journal of Gastroenterology 1996;91:718-722.
    · Sanders DS et al. A primary care cross-sectional study of undiagnosed adult coeliac disease. Eur J Gastroenterology and Hepatology 2003;4:407-413.
    · Meloni GF et al. The prevalence of coeliac disease in infertility. Hum Reprod 1999;14:2759-2761
    · Collins P et al. Infertility and coeliac disease. Gut 1996;39:382-384.
    · Molteni N et al. Obstetric and gynaecological problems with untreated sprue. Journal of Clinical Gastroenterology 1990;12:37-39.
    · Sher KS and Mayberry JF. Female fertility, obstetric and gynaecological history in coeliac disease. Digestion 1994;55:243-246.
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