Coeliac disease; Prevalence and Outcome in Pregnancy

Background: Coeliac disease (CD) is associated with infertility and adverse pregnancy outcomes. Furthermore, the aim of this study was to prospectively estimate the prevalence of undiagnosed CD in a population of pregnant women and pregnancy outcome. Methods: During the 2010-2011, 796 pregnant women were recruited for this study. The mean age was 26 years (SD=5.35) and mean pregnancy duration 5.4 months. Subjects underwent a total IgA test and antihuman IgA class antitissue transglutaminase (tTGA) antibodies and those tTGA positive underwent histological biopsy specimens according to UEGW classification. Results: From 796 pregnant women 17 (2.1%) had a positive CD serology for tTGA. Out of the 17 seropositive women, seven had normal histology, three had Marsh I, two had Marsh II, two had Marsh IIIa, two had Marsh IIIb and one had Marsh IIIc. Low birth weight babies were observed in 3 and two had a history of miscarriage in the past. Conclusion: In this study CD was not associated with a high incidence of unfavorable outcomes. Overall, 1/66 (1.5%) women had a confirmed CD. Despite pregnancy is acting as a triggering factor for manifestation of CD in susceptible individuals, untreated pregnant coeliac patients with a normal pregnancy should have reasonable compensatory capacities to enable them to complete their pregnancy without complications. Coeliac disease severity is variable in different individual and not every coeliac is at high risk for complication. This may suggest that gluten free diet could be avoided in some of patients who had a normal pregnancy.