Abstract
Celiac disease (CD) is a chronic autoimmune illness triggered by gluten consumption in genetically predisposed individuals. Worldwide, CD prevalence is approximately 1%. Several studies suggest a higher prevalence of undiagnosed CD in patients with infertility. We described reproductive disorders and assessed the frequency of hospital admissions for infertility among celiac women aged 15–49. We conducted two surveys enrolling a convenient sample of celiac women, residing in Apulia or in Basilicata (Italy). Moreover, we selected hospital discharge records (HDRs) of celiac women and women with an exemption for CD, and matched the lists with HDRs for reproductive disorders. In the surveys we included 91 celiac women; 61.5% of them reported menstrual cycle disorders. 47/91 reported at least one pregnancy and 70.2% of them reported problems during pregnancy. From the HDRs and the registry of exemption, we selected 4,070 women with CD; the proportion of women hospitalized for infertility was higher among celiac women than among resident women in childbearing age (1.2% versus 0.2%). Our findings highlight a higher prevalence of reproductive disorders among celiac women than in the general population suggesting that clinicians might consider testing for CD women presenting with pregnancy disorders or infertility.
Highlights
Celiac disease (CD) is a multifactorial chronic autoimmune systemic disease triggered by gluten consumption in genetically predisposed individuals [1].Worldwide, the prevalence of CD in the general population is approximately 1%; female : male ratio is 2 : 1 [2,3,4,5,6]
CD presents with gastrointestinal symptoms; it may be associated with extraintestinal signs and symptoms and in women with reproductive disorders [9, 10]
CD has been associated with recurrent spontaneous abortion [10,11,12,13,14,15,16,17,18,19,20], intrauterine growth restriction, preterm delivery and low-birth weight [11,12,13,14, 16,17,18,19,20,21,22,23,24,25,26,27], infertility, delayed menarche, early menopause, and stillbirth [11, 28,29,30,31,32]
Summary
Celiac disease (CD) is a multifactorial chronic autoimmune systemic disease triggered by gluten consumption in genetically predisposed individuals [1].Worldwide, the prevalence of CD in the general population is approximately 1%; female : male ratio is 2 : 1 [2,3,4,5,6]. In Europe, CD prevalence ranges between 0.5% in Germany and 2.4% in Finland [7]. CD presents with gastrointestinal symptoms; it may be associated with extraintestinal signs and symptoms and in women with reproductive disorders [9, 10]. CD has been associated with gynecologic disorders such as amenorrhea [10, 23, 31, 33]. These may even be the only presenting features and are considered atypical clinical forms of CD [11, 13,14,15, 34]
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