Clinical—alimentary tractCeliac Disease and Risk of Adverse Fetal Outcome: A Population-Based Cohort Study
Section snippets
Definition of Celiac Disease
We defined CD according to the following international classification of disease (ICD) codes: ICD-7: 286.00; ICD-8: 269.00, 269.98; ICD-9: 579A; ICD-10: K90.0. Women with a hospital-based discharge diagnosis of CD between 1964 and 2001 were identified through the Swedish national inpatient register. This individual-based information was obtained from the Swedish National Board of Health and Welfare. The national inpatient register has been described by Askling et al.3 This study was approved by
Background Data
Most women were 20–34 years of age when giving birth (Table 1). Few women reported smoking during pregnancy, and almost all women were of Nordic nationality. Among the 2078 women with CD, 1149 were diagnosed before birth, and 929 were undiagnosed (255 had a hospital discharge diagnosis of CD within less than 5 years after infant birth, and 674 received a hospital discharge diagnosis 5 years or more after infant birth). Only 3.8% of offspring to mothers with undiagnosed CD were born during the
Discussion
This study found that women with CD that was undiagnosed at the time of delivery were more likely to have a preterm birth; caesarean section; or have an offspring with IUGR, LBW, or VLBW. In contrast, maternal CD diagnosed before birth was not associated with adverse fetal outcomes. Our results underline the importance of screening for CD among women of reproductive age because some 1% of young people may have CD,6, 7, 8, 9, 10 and treatment seems to reduce dramatically the rate of
References (50)
- et al.
Fracture risk in people with celiac diseasea population-based cohort study
Gastroenterology
(2003) - et al.
Cancer incidence in a population-based cohort of individuals hospitalized with celiac disease or dermatitis herpetiformis
Gastroenterology
(2002) - et al.
Birth outcomes of women with celiac diseasea nationwide historical cohort study
Am J Gastroenterol
(1999) - et al.
Recurrent spontaneous abortion and intrauterine fetal growth retardation as symptoms of coeliac disease
Lancet
(2000) Intrauterine growth retardation
Am J Obstet Gynecol
(1970)- et al.
Fetal nutrition and adult disease
Am J Clin Nutr
(2000) - et al.
Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac diseasedisappointing in clinical practice (see comments)
Am J Gastroenterol
(1999) - et al.
Nutritional status of newly diagnosed celiac disease patients before and after the institution of a celiac disease diet—association with the grade of mucosal villous atrophy
Am J Clin Nutr
(1998) - et al.
Body composition and dietary intakes in adult celiac disease patients consuming a strict gluten-free diet
Am J Clin Nutr
(2000) - et al.
Relation between cigarette smoking and celiac diseaseevidence from a case-control study
Am J Gastroenterol
(2001)
Mortality in patients with coeliac disease and their relativesa cohort study
Lancet
Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac diseaseSIGEP Study Group for Autoimmune Disorders in Celiac Disease
Gastroenterology
Effect of gluten-free diet on bone mineral content in growing patients with celiac disease
Am J Clin Nutr
The molecular basis of celiac disease
J Mol Recognit
The prevalence of coeliac disease in infertility
Hum Reprod
Infertility and coeliac disease
Gut
High prevalence of undiagnosed coeliac disease in adultsa Swedish population-based study
J Intern Med
Undiagnosed coeliac disease at age sevenpopulation based prospective birth cohort study
BMJ
Undiagnosed coeliac disease does not appear to be associated with unfavourable outcome of pregnancy
Gut
Prevalence of celiac disease among children in Finland
N Engl J Med
Coeliac disease and unfavourable outcome of pregnancy
Gut
Celiac disease and pregnancy outcome
Am J Gastroenterol
Coeliac disease in the father affects the newborn
Gut
Coeliac disease, fertility, and pregnancy
Scand J Gastroenterol
Pregnancy in patients with coeliac disease
Br J Obstet Gynaecol
Cited by (174)
Reproductive complications in celiac disease patients in Slovenia
2019, European Journal of Obstetrics and Gynecology and Reproductive BiologyRecommendations regarding the genetic and immunological study of reproductive dysfunction
2019, Revista del Laboratorio ClinicoMaternal, obstetrical, and neonatal outcomes in celiac disease
2024, Scandinavian Journal of GastroenterologyNo Increased Risk of Cardiac Birth Defects in Infants of Mothers with Celiac Disease: A Population and Sibling Comparison
2023, American Journal of GastroenterologyThe Swedish medical birth register during five decades: documentation of the content and quality of the register
2023, European Journal of Epidemiology
Supported by grants from The Örebro Society of Medicine, The Sven Jerring Foundation, Karolinska Institute funds, The Swedish Society of Medicine, the Swedish Research Council, the Majblomman Foundation, and Örebro University Hospital (to J.F.L. [for manuscript preparation]).