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Coeliac disease and risk of birth defects in pregnancy
  1. Nathalie Auger1,
  2. Amelie Therrien2,
  3. Marianne Bilodeau-Bertrand3,
  4. Chantal Nelson4,
  5. Laura Arbour5
  1. 1 Department of Social and Preventive Medicine, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
  2. 2 Celiac Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3 Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada
  4. 4 Maternal and Infant Health Surveillance Section, Public Health Agency of Canada, Ottawa, Ontario, Canada
  5. 5 Department of Medical Genetics, The University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Nathalie Auger, University of Montreal Hospital Centre, Montreal, QC H2W 1T8, Canada; nathalie.auger{at}

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Coeliac disease (CD) is prevalent in patients of reproductive age, but the impact on pregnancy and fetal development is unclear. The British Society of Gastroenterology recommends serological testing for CD in patients with chronic diarrhoea,1 but CD may be under-recognised in women without the classic symptoms.2 We studied the association between CD and the risk of birth defects in pregnant women.

We analysed a cohort of live births between 1989 and 2016 in Quebec, Canada using discharge summaries from the Maintenance and Use of Data for the Study of Hospital Clientele database. We used diagnostic codes to identify women with CD and infants with different types of birth defects. We determined whether CD was present during prenatal follow-up, or if women required hospitalisation for CD before or after pregnancy. We used log-binomial regression models with robust SE to estimate associations between CD and birth defects adjusted for maternal characteristics.

This study comprised 2 184 888 infants, …

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  • Contributors NA and MBB conceived and designed the study. MBB analysed the data, with input from NA. AT, CN and LA helped interpret the results. AT and MBB drafted the manuscript, and NA, CN and LA revised it for important intellectual content. All authors approved the final version for publication.

  • Funding This work was supported by Grant 6D02363004 from the Public Health Agency of Canada, and by Career Awards 34695 (NA) and 267222 (AT) from the Fonds de recherche du Québec-Santé.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.