Celiac Disease and Pregnancy

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Although I am pretty sure that I had Celiac Disease for more than two decades before my diagnosis, I was not diagnosed until after my 3rd child was born. Looking back, my diet during my first 3 pregnancies was a gluten-filled nightmare. I am actually glad that I have no idea how sky-high my celiac antibodies probably were while I was pregnant with my oldest kids.

There has not been a ton of research on celiac disease and pregnancy, but based on the work that has been done, I have learned that celiac disease has effects on fertility, miscarriage rates, fetal growth, and the ability to carry a pregnancy to term.

Celiac disease is associated with early menopause, endometriosis, irregular menstrual cycles, and amenorrhea (missed periods), similar to what is seen in many other autoimmune diseases.

Between 4 to 8% of unexplained infertility is due to undiagnosed celiac disease. Many celiacs with infertility as their main problem do not have the “classic” digestive symptoms that would normally lead to diagnosis.

Once pregnant, women with undiagnosed celiac disease have between a 2-4x higher risk of miscarriage than women who do not.

During pregnancy, women with untreated celiac disease are at a higher risk of anemia, preterm labor, stillbirth, and having infants with low birth weights (growth restriction). These problems are related to a combination of maternal nutrient deficiencies during pregnancy, as well as effects from the attack of the placenta by maternal auto antibodies (TTG).

As a part of taking care of premature babies, it is important for me to review the medical and obstetric histories of my patients’ mothers. I have come across women more times than I can keep track of who, upon review of their medical records, may have celiac disease (some combination of irritable bowel syndrome, anemia, thyroid disease, depression, infertility, diabetes, and/or asthma). I have a friend who did a small research study during her fellowship in which she evaluated the mothers of low birth weight babies for celiac disease. Through her study, one mother was diagnosed with celiac disease. Similar research has recently been conducted in Italy, with results mirroring my friend’s.

Based on the information on the University of Chicago Celiac Disease Center website, once a woman is diagnosed with celiac disease and on a strict gluten free diet, fertility should return. Experts have recommended waiting between 6 months to 2 years once being gluten free before trying to conceive, in order to give the body time to heal. It is essential for celiacs to be on appropriate vitamin and mineral supplementation while pregnant.

It is assumed that pregnancy outcomes for women with treated celiac disease are similar to those of women without it. The only exception is that celiacs are still at a higher risk of miscarriage, even when we are gluten free during pregnancy. I have personally experienced this; back in 2011 I miscarried within days of bad “glutening” episode.

In summary, women with unexplained infertility should be screened for celiac disease. Once diagnosed, it is important to remain strictly gluten free and take a good gluten free prenatal vitamin while pregnant. One of the best resources to check the gluten status of a medication is at www.glutenfreedrugs.com. Last of all, try not to worry about the effects of celiac disease on your baby! Treated maternal celiac disease has no association with birth defects, heart problems, cerebral palsy, etc. However, if you are like me, you will worry about your baby throughout your entire pregnancy…this is a totally normal part of being a mom!

For additional reading on celiac disease and pregnancy, I recommend the following links:

1. The National Foundation for Celiac Awareness’ 2009 article “Pregnancy and Celiac Disease.”

2. “Celiac Disease: An underappreciated issue in women’s health” by Shah, S (2010).

Thank you for continuing to read and providing inspiration for posts!

Update September 2013: A group of Italian researchers has discovered that the type 2 tissue transglutaminase (TTG) antibodies seen in Celiac Disease interfere with the development of placental blood vessels. Reference is Simone, et al. Potential New Mechanisms of Placental Damage in Celiac Disease: Anti-Transglutaminase Antibodies Impair Human Endometrial Angiogenesis. Biol Reprod. Sept. 5, 2013. E-pub, ahead of print.

 

 

5 thoughts on “Celiac Disease and Pregnancy

  1. Chris DBates ( a lot of stuff)

    Thank You for sharing the information. When we discover what is going on a fear factor goes out that others really do need to know. How could they have missed all the symptoms while I was growing up? Anyways, Thanks again, and Be Blessed you found it, some do not get that chance. My Mother, her brother, her sister and my little brother all had colon cancer twice. My lil brother passed away at 42, he didn’t get to know, and it seems it is hereditary. Still wondering why we had to go down a road of sickness for many years and surgeries, and deaths, then only I got to know? God Bless, Keep up the great work.

    1. Jess Post author

      Hi Chris,
      Thanks for reading and for your support!
      I am thankful for being diagnosed while still relatively young, and in this day and age where we can easily share information through the internet. My heart goes out to those who suffered alone for years and years (and to those who still suffer today without a diagnosis). I hope as more of us speak out about celiac disease that awareness will increase and suffering decrease! All the best to you….
      Jess

  2. Pingback: Let’s Talk about Celiac Disease and Infertility | The Patient Celiac

  3. Kristin

    As a woman who has also experienced a miscarriage and subsequent infertility, I have tried to find any information regarding Celiac Disease affecting pregnancy even while adhering to a strict gluten-free diet. I was diagnosed many years before attempting to become pregnant and have followed a strict gluten-free diet for 11 years now. Most information says that “once on a gluten-free diet, fertility should resume within about 6 months” – but I would really like to know if Celiac Disease in and of itself – even if on a gluten-free diet – still affects pregnancy and infertility in women. I seem to be one case of it possibly…. but I just don’t know.

    1. Jess Post author

      Hi Kristin,
      You are so right about all of the information that states that fertility should resume once on the GF diet…although this comment has been made on a lot of websites and articles by researchers, I was unable to find any well designed studies to support this. I think that, like so much of the information with Celiac Disease, a lot of the information out there is anecdotal. I continually have to remind myself that just 25 years ago it was believed that children with celiac disease would “outgrow” it!
      Do you suffer from any other autoimmune diseases? A lot of the women I encounter with infertility and Celiac Disease in my line of work also seem to have other autoimmune processes going on (fibromyalgia, polycystic ovarian syndrome, etc.)
      Thank you for sharing your story, as I am sure that it will help another woman to read your comment and know that she is not alone.
      Jess

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