title: Gluten consumption during late pregnancy and risk of celiac disease in the offspring: the TEDDY birth cohort.
abstract: BACKGROUND
  Maternal diet during pregnancy has been proposed to increase the risk of autoimmune diseases.
  
  
  OBJECTIVE
  The objective was to investigate the association between maternal consumption of gluten-containing foods during late pregnancy and subsequent risk of celiac disease in the offspring.
  
  
  METHODS
  Genetically susceptible children prospectively followed from birth were screened annually for tissue transglutaminase autoantibodies (tTGAs). Children testing persistently positive for tTGAs were further evaluated for celiac disease. Diagnosis of celiac disease was confirmed by intestinal biopsy or was considered likely if the mean tTGA concentration was >100 units in 2 consecutive samples. A questionnaire on the mother's diet in late pregnancy was completed by 3-4.5 mo postpartum. Mothers were divided into 3 groups based on the tertiles of their consumption of gluten-containing foods (servings/d). The association between maternal gluten-containing food consumption and the risk of celiac disease was studied by using a time-to-event analysis.
  
  
  RESULTS
  At the time of analysis, 359 (5%) of the 6546 children developed celiac disease. Compared with the middle category of maternal gluten-containing food consumption (servings/d), low (HR: 0.87; 95% CI: 0.67, 1.13; P = 0.296) and high (HR: 0.84; 95% CI: 0.65, 1.09; P = 0.202) consumption was not associated with risk of celiac disease in the child after adjustment for country, human leukocyte antigen genotype, family history of celiac disease, maternal education, and sex of the child. Median maternal daily consumption frequency of gluten-containing foods was higher (P < 0.0001) in Finland (5.3; IQR: 3.9-6.9), Germany (4.3; IQR: 3.1-5.5), and Sweden (3.7; IQR: 2.8-4.9) than in the United States (3.4; IQR: 2.3-4.9). No significant interaction was found between country of residence and the mothers' consumption of gluten-containing foods in relation to risk of celiac disease.
  
  
  CONCLUSIONS
  The frequency of gluten-containing food consumption during late pregnancy is not associated with risk of celiac disease in the offspring.
authors.affiliation: Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL;
authors.forename: Ulla
authors.initials: U
authors.lastname: Uusitalo
authors.affiliation: Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL;
authors.forename: Hye-Seung
authors.initials: HS
authors.lastname: Lee
authors.affiliation: The Diabetes and Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden;
authors.forename: Carin Andrén
authors.initials: CA
authors.lastname: Aronsson
authors.affiliation: Health Informatics Institute, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL;
authors.forename: Jimin
authors.initials: J
authors.lastname: Yang
authors.affiliation: Unit of Nutrition, National Institute for Health and Welfare, Helsinki, Finland, Tampere, Finland, Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland, and Science Center of Pirkanmaa Hospital District, Tampere, Finland; and.
authors.forename: Suvi M
authors.initials: SM
authors.lastname: Virtanen
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
authors.forename: Jill
authors.initials: J
authors.lastname: Norris
authors.affiliation: The Diabetes and Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; daniel.agardh@med.lu.se.
authors.forename: Daniel
authors.initials: D
authors.lastname: Agardh
mesh_terms: D001323:Autoantibodies / Q000032:analysis; D002446:Celiac Disease / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D015331:Cohort Studies; D055050:Diet, Gluten-Free; D004044:Dietary Proteins / Q000008:administration & dosage / Q000009:adverse effects*; D005060:Europe / Q000453:epidemiology; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012307:Risk Factors; D011503:Transglutaminases / Q000037:antagonists & inhibitors; D014481:United States / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D004044:Dietary Proteins; D005983:Glutens; D011503:Transglutaminases
keywords: celiac disease; gluten; maternal consumption; offspring; pregnancy