title: Increased rates of pregnancy complications in women with celiac disease.
abstract: BACKGROUND
  Celiac disease is an immune-mediated small bowel disorder that develops in genetically susceptible individuals upon exposure to dietary gluten. Celiac disease could have extra-intestinal manifestations that affect women's reproductive health. The aim of this study was to investigate fertility and outcomes of pregnancy among women with celiac disease.
  
  
  METHODS
  In a retrospective cohort study, we analyzed information collected from patients at a tertiary care celiac center and from members of 2 national celiac disease awareness organizations. Women without celiac disease were used as controls. Women completed an anonymous online survey, answering 43 questions about menstrual history, fertility, and outcomes of pregnancy (329 with small bowel biopsy-confirmed celiac disease and 641 controls).
  
  
  RESULTS
  Of the 970 women included in the study, 733 (75.6%) reported that they had been pregnant at some point; there was no significant difference between women with celiac disease (n=245/329, 74.5%) and controls (488/641, 76.1%; P=0.57). However, fewer women with celiac disease than controls (79.6% vs. 84.8%) gave birth following 1 or more pregnancies (P=0.03). Women with celiac disease had higher percentages of spontaneous abortion than controls (50.6% vs. 40.6%; P=0.01), and of premature delivery (23.6% vs. 15.9% among controls; P=0.02). The mean age at menarche was higher in the celiac disease group (12.7 years) than controls (12.4 years; P=0.01).
  
  
  CONCLUSIONS
  In a retrospective cohort analysis examining reproductive features of women with celiac disease, we associated celiac disease with significant increases in spontaneous abortion, premature delivery, and later age of menarche.
authors.affiliation: Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia PA (Stephanie M. Moleski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, Anthony J. DiMarino), USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Moleski
authors.affiliation: Division of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland (Christina C. Lindenmeyer), USA.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Lindenmeyer
authors.affiliation: Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia (J. Jon Veloski, Robin S. Miller), USA.
authors.forename: J Jon
authors.initials: JJ
authors.lastname: Veloski
authors.affiliation: Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia PA (Stephanie M. Moleski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, Anthony J. DiMarino), USA.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Miller
authors.affiliation: Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia PA (Stephanie M. Moleski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, Anthony J. DiMarino), USA.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Miller
authors.affiliation: Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia PA (Stephanie M. Moleski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, Anthony J. DiMarino), USA.
authors.forename: David
authors.initials: D
authors.lastname: Kastenberg
authors.affiliation: Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia PA (Stephanie M. Moleski, Robin S. Miller, Cynthia L. Miller, David Kastenberg, Anthony J. DiMarino), USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: DiMarino
keywords: Celiac disease; fertility; gluten; nutrition; women’s health
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