Women who experience recurrent miscarriages or
those whose fetuses show intrauterine growth retardation may have undiagnosed
celiac disease.
Celiac disease is a genetic condition that causes
those afflicted to experience difficulty absorbing gluten, as found in
wheat, oats, barley, and several other grains. Symptoms include diarrhea,
abdominal distention, and fatigue. And research suggests that more people
may have a symptomless, milder form that may often go undetected. Recent
studies have indicated that many people are found to have mild forms of
the disease when their blood is tested for the condition, even though
they were unaware that there was a problem.
Women who experience repeat miscarriages, also
known as recurrent spontaneous abortions (RSA) or intrauterine growth
retardation (IUGR) -- a condition in which a baby is born significantly
smaller than normal -- may have celiac disease that has gone undetected.
Researchers, led by Dr. Antonio Gasbarrini, explain
that they decided to look at celiac disease since it is a common cause
of malabsorption of food in western countries. And for some time, miscarriages
have been correlated with celiac disease.
Gasbarrini and colleagues conducted blood tests
for the condition in 44 patients with RSA, 39 with IUGR, and 50 healthy
women. None of the healthy women were found to have celiac disease, but
the condition was detected in 8% of the women with RSA and 15% of those
with IUGR.
Biopsy samples from the intestine confirmed diagnosis
in eight of nine patients whose blood tested positive for the disease.
Women having recurrent miscarriages or intrauterine
growth retardation could have subclinical celiac disease, which will usually
go undetected.
Celiac disease has been correlated with infertility,
and with other conditions, including birth defects in children whose mothers
could not absorb folic acid while pregnant because they had undiagnosed
celiac disease, she said. It makes sense that the condition could lead
to other problems related to too little nutritional intake, she pointed
out. Spontaneous abortions could feasibly result if the mother was failing
to absorb vitamins and minerals required by the baby, researchers explained.
If celiac disease is responsible for some of these problems, it is easily
treatable by avoiding products containing gluten.
The Lancet
July 29, 2000;356:399-400