Effect of celiac disease on maternal and neonatal outcomes of pregnancy.

Elliott, Brittney; Czuzoj-Shulman, Nicholas; Spence, Andrea R.; Mishkin, Daniel S.; Abenhaim, Haim Arie

Purpose: Celiac disease (CD) is a permanent immune reaction to gluten that is likely related to genetic factors. Some studies have linked CD to adverse maternal and/or neonatal outcomes but the data has been contradictory. The purpose of this study was to evaluate the effect of CD on pregnancy outcomes.Materials and Methods: We used data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (NIS) of the USA to conduct a population-based retrospective cohort study of women who delivered between 1999 and 2014. Pregnancies were categorized as having CD if corresponding ICD-9 code was present. Unconditional logistic regression models were used to estimate the adjusted effect on maternal and fetal outcomes.Results: There were 14,513,587 births during the study period of which 2755 were to women with CD, for an overall prevalence of 1.9 cases/10,000 births and with rates increasing over the study period. Women with CD tended to be older, Caucasian and to have pre-existing comorbidities, especially other autoimmune diseases. Women with CD were at greater risk of hyperemesis gravidarum, 4.52 (3.68-5.57), Clostridium difficile colitis, 7.56 (3.14-18.20), and venous thromboembolic events, 2.93 (2.07-4.15), as well as, hospital stays >3 d, 2.06 (1.75-2.43). Infants of women with CD were more likely to be growth restricted, 1.80 (1.46-2.21) and have congenital malformations, 3.51 (2.68-4.58).Conclusions: CD in pregnancy is associated with increased adverse maternal and newborn complications. These pregnancies should be considered high risk and may benefit from increased surveillance.

CELIAC disease; PREGNANCY outcomes; NEONATAL diseases; MORNING sickness; CLOSTRIDIOIDES difficile; NEWBORN infants; RETROSPECTIVE studies; PREGNANCY complications; LONGITUDINAL method

Journal of Maternal-Fetal & Neonatal Medicine, 2021, Vol 34, Issue 13, p2117

1476-7058

Academic Journal

10.1080/14767058.2019.1658733