Celiac Disease: Fertility and Pregnancy
January 21, 2001
Celiac disease (gluten-sensitive enteropathy) may manifest clinically with an array of nongastrointestinal symptoms among which are:
dental enamel defects
various neurological symptoms
anemia of various types
Important data have accumulated in recent years regarding the association between celiac disease, fertility and pregnancy. Many primary care obstetricians and gynecologists and
perinatologists are not aware of these important relationships.
The aim of this review, utilizing a MEDLINE search from 1966 through March 2000 of the English language, is to describe the possible effects of celiac disease and its treatment upon the reproductive cycle, fertility, pregnancy, and menopause. Review of the literature reveals that patients with untreated celiac disease sustain a significantly delayed menarche, earlier menopause, and an increased prevalence of secondary amenorrhea.
Patients with untreated celiac disease incur:
- higher miscarriage rates
- increased fetal growth restriction
- lower birth weights
It appears that improvement of celiac disease, as reflected by restoration of small bowel mucosa associated with implementation of a gluten-free diet, may decrease miscarriage rates, improve fetal nutritional support and overall perinatal outcome.
Gynecol Obstet Invest 2001;51:3-7