Celiac Disease During Pregnancy: What You Need to Know

When you’re expecting a new baby, it is important to prioritize your health and nutrition. This can be a challenge in and of itself when you’re struggling with morning sickness and combating cravings for unhealthy foods. Having celiac disease adds an extra level of difficulty to the equation and it also makes balanced nutrition an even bigger priority.

Generally speaking, the gluten free diet can be low in key nutrients including calcium, iron, B vitamins, fiber, zinc, vitamin D, and magnesium. In order to ensure that your developing baby gets the nutrients he or she needs to grow, you may need to be a little more mindful of your diet during pregnancy.

Keep reading to learn more about managing celiac disease during pregnancy including an overview of how celiac disease affects pregnancy, what challenges you should expect, and some simple tips for keeping both you and your baby health.

Celiac disease is one of the most common autoimmune diseases in the world and yet researchers are still struggling to fully understand it. Because it presents in a variety of different ways, celiac disease often goes undiagnosed for months or years which can lead to some pretty serious health problems including chronic fatigue and malnutrition. Even when properly managed, celiac disease can contribute to some health challenges – especially when you are pregnant.

Once thought to be a children’s malabsorptive disease, celiac disease causes symptoms that go well beyond gastrointestinal problems like diarrhea and vomiting. In fact, new research suggests that there may be link between celiac disease and reproductive disorders in women. Untreated celiac disease has been linked with a shorter fertile lifespan, shorter breastfeeding periods, and low fertility rates. Most of these issues were resolved when the patient switched to a gluten free diet, but there is some concern that having celiac disease could affect pregnancy even when the patient is eating gluten free.

In a literature review published by Human Reproduction Update in March or 2014, lead author Dr. Chiara Tersingi identifies two mechanisms through which celiac disease affects pregnancy: nutritional deficiency and autoimmune mechanisms.

In terms of nutritional deficiencies, celiac disease can be associated with deficiencies in selenium, zinc, and folic acid – all of these are important nutrients for healthy pregnancy. When it comes to autoimmune mechanisms and their effect on pregnancy, there are two possibilities. The first possibility is that anti-transglutaminase (tTG) antibodies bind to the embryo and cause damage to the placenta. The second possibility is that the anti-tTG antibodies harm the endometrial endothelial cells of the mother.

More study is required for all of these possibilities, but the research suggests that proper nutrition during pregnancy is of particular importance for women with celiac disease.

Any woman who is pregnant is at-risk for a variety of complications. Miscarriage, iron-deficiency anemia, and premature birth are all risks that any pregnant woman should be aware of. You may be surprised to learn, however, that women with celiac disease experience pregnancy problems and complications at a much higher rate – about two to four times the rate of women without celiac disease.

An Italian study published in 2010 gathered data on the incidence of reproductive disorders and pregnancy complications in women with celiac disease. Out of all the participants, 65% of women with celiac disease reported at least one gestational disorder during their pregnancy compared to 31% of women without celiac disease. At the time of pregnancy, 85% of women had not been diagnosed.

Here is an overview of some of the pregnancy problems and complications identified in that study:

• Roughly 41% of celiac women experienced severe anemia during pregnancy compared to 2% of control subjects.
• Only 9% of non-celiac women experienced threatened abortion or threatened miscarriage compared to 39% of celiac women.
• Placental abruption, a condition in which the placenta separates from the wall of the uterus, affected 1% of control women but 18% of celiac women.
• None of the control women experienced gestational hypertension compared to 10% of women with celiac disease.
• Abnormal uterine muscle activity known as uterine hyperkinesia affected 10% of celiac women and none of the control subjects.
• Improper growth rate known as intrauterine growth restriction affected more than 6% of celiac women but none of the control subjects.

Other research has shown a link between celiac disease and low birth-weight. The risk for low birth-weight seems to be higher in women with undiagnosed celiac disease and these women also tend to have shorter pregnancies – up to two weeks shorter. Women with celiac disease also require cesarean sections more frequently than non-celiac women. There is also some evidence to suggest that babies born by C-section have a higher risk of developing celiac disease themselves later on.

Keep in mind that many of the pregnancy problems and complications in women with celiac disease either go away completely or are greatly reduced when the woman switches to a gluten free diet. Serious complications like infertility and miscarriage are much more likely in women with undiagnosed celiac disease than in women with celiac disease who follow a gluten free diet.

Keep reading to receive some tips for keeping you and your baby healthy during pregnancy.

Your baby’s health is directly linked to your own, so you need to take care of yourself if you want to take care of your baby. If you’re pregnant and you’ve already experienced pregnancy problems, you may want to get tested for celiac disease, particularly if you’ve also had digestive symptoms, chronic fatigue, or other health problems.

If you’ve already been diagnosed with celiac disease, here are some simple things you can do to keep yourself and your baby healthy for the duration of your pregnancy:

• Eat plenty of iron-rich foods to prevent anemia. These include dark leafy greens, beef, lamb, sweet potatoes, broccoli, and peas.
• Make sure you’re getting enough folic acid to promote healthy brain development in your baby. Food sources include pinto beans, black beans, lentils, dark leafy greens, citrus fruits, broccoli, and peanuts.
• Support healthy bone development by getting plenty of calcium, vitamin D, and magnesium. If you also have lactose intolerance, look for nondairy sources like canned fish, leafy greens, and calcium-fortified beverages.
• Increase your intake of omega-3 fatty acids or take fish oil supplements. Natural sources for omega-3s include tuna, salmon, sardines, and lake trout.
• Get your daily dose of activity by taking a walk. Talk to your doctor about the appropriate level of physical activity for your health and fitness level.
• Consider having some bloodwork done. If you’ve been newly diagnosed with celiac disease, you may already have some nutritional deficiencies. Bloodwork will help your doctor determine which nutrients you are deficient in and how best to resolve those deficiencies.
• Be sure to include whole grains in your diet. Many pregnant women experience constipation during their second or third trimester. You can combat this by increasing your intake of gluten free whole grains like teff and quinoa.

Because untreated celiac disease greatly increases your risk for pregnancy complications, you need to adhere to the gluten free diet as strictly as possible. Stock up on gluten free snacks like bread and crackers for those days when you’re having carb cravings and do your best to eat a variety of gluten free foods to ensure nutritional balance in your diet. You might also want to talk to your doctor about nutritional supplements just to be sure you’re hitting your daily recommended allowance.

Every woman’s body is unique, so your pregnancy experience will be completely your own. The best thing you can do is stay committed to your gluten free diet and make an effort to get the right balance of nutrients. Be sure to talk to your doctor about ways to ensure balanced nutrition and to stay on top of any pregnancy problems you might be experiencing.