News Alerts  May 1, 2013--------News Archive

Celiac disease is associated with infertility in both men and women. Clinically, women with celiac disease can also present with amenorrhea, delayed menarche (a delay in the onset of the first period) and menstrual irregularities, miscarriage, fewer live births, endometriosis, severe anemia during pregnancy and other pregnancy complications.1,2,3,4 Celiac disease may initially present during pregnancy or post partum.1,4 Celiac disease in men may also contribute to children born prematurely or with lower birthrates. In pregnancy, celiac disease is associated with a high rate of miscarriage, delayed intrauterine growth, low birth weight and premature births. MichelleRossNutrition.com Credit: Image: www.fashioncentral.pk

Celiac disease increases risk for low birth weight babies

The antibody tissue transglutaminase (anti-tTG) is most commonly found in patients with celiac disease. Pregnant women with mid to high levels of anti-tTG are at risk for having babies with reduced fetal weight and birth weight.

"While several observational studies have suggested that celiac disease is associated with different pregnancy outcomes, this research takes into account the actual levels of tissue transglutaminase that reflect the degree of mucosal damage associated with undiagnosed celiac disease or limited compliance to a gluten-free diet. This differentiation is critical since most celiac disease cases remain undiagnosed," said Jessica Kiefte-de Jong, MSc, Erasmus University Medical Center, and lead author of the study.

The new study appears in Gastroenterology, the official journal of the American Gastroenterological Association.

Researchers conducted a population-based birth cohort study of 7,046 pregnant women, and categorized subjects into three groups: negative anti-tTG (control), intermediate anti-tTG (just below the clinical cut-off point used to diagnose patients with celiac disease) and positive anti-tTG (highly probable celiac disease patients). Fetuses of women with positive anti-tTG weighed 16 grams less than those of women with negative anti-tTG levels during the second trimester and weighed 74 grams less during the third trimester.

People with intermediate anti-tTG levels are generally not considered to be potential celiac disease patients, yet birth outcomes for these individuals were also affected.

Infants of women with intermediate and positive anti-tTG weighted 53 grams and 159 grams less at birth, respectively, than those of women with negative anti-tTG.

"Researchers need to explore the natural history and long-term consequences of intermediate anti-tTG levels to determine if these levels are caused by pregnancy or whether it reflects a subclinical state of celiac disease that needs follow-up," added Jong.

Helping identify the connection between anti-tTG levels and celiac disease, a study in Clinical Gastroenterology and Hepatology reconfirmed the recent European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines, which recognized the likelihood for celiac disease increases with increasing antibody concentration.

Research from University Hospitals Leuven, Belgium, stresses the importance of also monitoring for relevant symptoms, such as weight loss, failure to thrive, anemia, iron deficiency or fatigue, when diagnosing patients, and notes that physicians should not rely solely on anti-tTG testing to make a diagnosis.

The study found a 50 to 75 percent chance that people without symptoms, but with anti-tTG levels more than 10 times the cutoff value (as defined in the ESPGHAN guidelines) will have celiac disease. The probability a patient has celiac disease rises to 95 percent or more when, in addition to high anti-tTG levels, the patient's complaints can be associated with celiac disease.

Learn more about celiac disease in the AGA brochure "Understanding Celiac Disease" at http://www.gastro.org/patient-center/digestive-conditions/celiac-disease.

About the AGA Institute
The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. http://www.gastro.org.

About Gastroenterology
Gastroenterology, the official journal of the AGA Institute, is the most prominent scientific journal in the specialty and is in the top 1 percent of indexed medical journals internationally. The journal publishes clinical and basic science studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, Current Awareness in Biological Sciences, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit http://www.gastrojournal.org.

Original article: http://www.gastro.org/news/articles/2013/04/29/pregnant-women-with-high-celiac-disease-antibodies-are-at-risk-for-low-birth-weight-babies