Perinatal Outcome and Long-Term Gastrointestinal Morbidity of Offspring of Women with Celiac Disease.

Abecassis Abecassis,Wainstock Wainstock,Pariente Pariente,Sheiner Sheiner

doi:10.3390/jcm8111924

Abecassis Abecassis, Wainstock Wainstock + Show 2 more

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https://doi.org/10.3390/jcm8111924

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Abstract

The aim of this study was to evaluate perinatal outcome and long-term offspring gastrointestinal morbidity of women with celiac disease. Perinatal outcomes, as well as long-term gastrointestinal morbidity of offspring of mothers with and without celiac disease were assessed. The study groups were followed until 18 years of age for gastrointestinal-related morbidity. For perinatal outcomes, generalized estimation equation (GEE) models were used. A Kaplan–Meier survival curve was used to compare cumulative incidence of long-term gastrointestinal morbidity, and Cox proportional hazards models were constructed to control for confounders. During the study period, 243,682 deliveries met the inclusion criteria, of which 212 (0.08%) were to mothers with celiac disease. Using GEE models, maternal celiac disease was noted as an independent risk factor for low birth weight and cesarean delivery. Offspring born to mothers with celiac disease had higher rates of gastrointestinal related morbidity (Kaplan–Meier log rank test p < 0.001). Using a Cox proportional hazards model, being born to a mother with celiac disease was found to be an independent risk factor for long-term gastrointestinal morbidity of the offspring. Pregnancy of women with celiac disease is independently associated with adverse perinatal outcome as well as higher risk for long-term gastrointestinal morbidity of offspring.

Highlights

Celiac disease, a gluten sensitive enteropathy, is a chronic autoimmune disorder affecting the normal villous structure in the small intestine
Our study has shown higher rates of adverse perinatal outcomes among women with celiac disease, such as several cesarean delivery and low birthweight
Offspring born to mothers with celiac disease had higher rates of long-term total gastrointestinal morbidity and higher rates of celiac disease and gastro-duodenal disease compared to offspring of women without celiac disease

Summary

Introduction

A gluten sensitive enteropathy, is a chronic autoimmune disorder affecting the normal villous structure in the small intestine. Preterm delivery [7,8], intrauterine growth restriction (IUGR) [9,10], and low birth weight [11] are some of the obstetric complications that have been demonstrated to be associated with celiac disease. These pregnancy complications associated with celiac raise the question of importance of celiac screening during pregnancy [5]

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