Infertility, small for dates babies, miscarriages and unexplained stillbirths are tragic events for a couple trying to conceive. If this should be occurring, I recommend screening for celiac disease or gluten sensitivity because there is a higher incidence of these problems; with small for dates babies, there is a 7.75 times increased incidence according to this study.
This report comes from Jefferson Adams.
Dr. Kumar, of Maulana Azad Medical College & Lok Nayak Hospital in New Delhi, reported in a study published in the World Journal of Gastroenterology that women with latent celiac disease, those who test positive for celiac antibodies but show normal small bowel biopsies, may develop more reproductive problems.
"Women having unexplained infertility, recurrent abortions, stillbirths or intrauterine growth retardation could have subclinical celiac disease, which can be detected by serological screening tests," Dr. Ashok Kumar told Reuters Health by email.
Improved diagnostic tools, and greater access to screening have led to more diagnosis of latent or subclinical celiac disease, says Dr. Kumar.
Doctors know that women with full, biopsy-proven, untreated celiac disease have more reproductive problems if they don't follow a gluten-free diet.
To study the effect of latent celiac disease on reproductive performance, the researchers examined 893 women.
They found that a total of 104 women had undergone idiopathic recurrent abortion, 104 had unexplained stillbirth, 230 had unexplained infertility, and 150 were pregnant, but showed idiopathic intrauterine growth restriction. The remaining 305 women, with normal obstetric histories, and served as control subjects.
Based on IgA tTG antibody titers, latent celiac disease was 5.43 times more common in the group with recurrent spontaneous abortion than in the control group.
Rates of latent celiac disease for the group with stillbirth were 4.61 times greater than the control group.
Rates for the group with intrauterine growth restriction were 7.75 times greater than control subjects, while rates for those with unexplained infertility were 4.51 higher.
The researchers also found that women with positive blood screens showed higher rates of previous early births, low-weight births, and cesarean sections than did seronegative subjects.
Moreover, the researchers note that "the classic presentation of diarrhea and malabsorption is now less common, and atypical and silent presentations are increasing."
As a result of their findings, Dr. Kumar and his colleagues are recommending celiac disease blood screens for women with idiopathic cases of poor reproductive performance.