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Celiac disease (gluten-sensitive
enteropathy) may manifest clinically with an array of nongastrointestinal
symptoms among which are:
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dermatitis
herpetiformis
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osteoporosis
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dementia
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osteomalacia
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depression
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dental
enamel defects
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various
neurological symptoms
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anemia
of various types
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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
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