165: Maternal celiac disease and long-term gastrointestinal morbidity of the offspring

Abstract

The development and availability of diagnosis made the prevalence of celiac disease to increase over the past 20 years. Celiac disease has been associated with adverse short-term perinatal outcomes such as low birth- weight and preterm delivery. The aim of the present study was to determine whether being born to a mother with celiac disease increases the risk for long-term gastrointestinal morbidity of the offspring. A population-based cohort study, comparing long-term gastrointestinal morbidity of offspring of mothers with and without celiac disease was conducted. All singleton deliveries between the years 1991-2014 in a tertiary medical center were included. Cases of perinatal mortality, children with congenital malformations or chromosomal abnormalities and pregnancies without prenatal care were excluded from the study. The study groups were followed until 18 years of age for gastrointestinal -related morbidity. The risk of long-term gastrointestinal morbidity in offspring was based on the hospital’s pediatric database and a pre-defined set of gastrointestinal ICD-9 code list associated with hospitalizations of the offspring. A Kaplan-Meier survival curve was used to compare cumulative incidence of long- term gastrointestinal morbidity, and a Cox proportional hazards model was constructed to control for confounders. During the study period 242,342 deliveries met the inclusion criteria, of them 0.9% (n=210) were of mothers with celiac disease. Offspring born to mothers with celiac disease had higher rates of gastrointestinal related morbidity (Table). Likewise, the cumulative incidence of long-term gastrointestinal morbidity was higher as compared with those without celiac disease (Kaplan-Meier log rank test P<0.001, Figure). Using a Cox proportional hazards model, controlling for confounders such as maternal age, hypertensive disorders, birth-weight and maternal diabetes mellitus, being born to a mother with celiac disease was found to be an independent risk factor for long-term gastrointestinal morbidity of the offspring (adjusted HR 2.53, 95% CI 1.63-3.93; P<0.001). Being born to a mother with celiac disease is independently associated with higher risk for long-term gastrointestinal morbidity of the offspring.View Large Image Figure ViewerDownload Hi-res image Download (PPT)