Mothers who were unaware that they suffered from gluten intolerance during their pregnancy were twice as likely to have babies weighing less than 2500 grams, while two-and-a-half times more likely to have babies weighing less than 1500 grams. They were also just over 50% more likely to be delivered by caesarean section.
The findings, published in the August volume of the journal Gastroenterology, are the result of a study by a team at Karolinska Institute that compared the health of 1149 babies born to mothers with diagnosed gluten intolerance, and 929 babies of undiagnosed mothers, with 2.8 million babies born to women who never received a diagnosis.
“Our study reveals that someone who is gluten intolerant should be eating a gluten free diet for at least one to two years before becoming pregnant in order for the risk of low birth weight to be the same as the general population,” said lead investigator Dr. Jonas F Ludvigsson.
He suggests doctors should be made more aware of this link, although they do not believe routine screening for all pregnant women is necessary. He tells the Local; “[only] women who show symptoms of CD (gluten intolerance) during pregnancy should undergo auto-antibody screening, a procedure that is well known and ready established in Western countries.”
Ludvigsson could not quantify how much of a difference there might be if the woman became aware of her gluten intolerance long before she got pregnant, compared to being diagnosed during pregnancy.
It is thought that the negative dietary effects of gluten intolerance in the mothers mean that the baby is not getting essential nutrients in the womb. Furthermore, the inflammation that occurs in the small bowel affects the whole body, so probably also the womb. “I am not sure why, but the inflammation affects when the baby is born,” Ludvigsson told news agency TT.
It is estimated that about one in every two hundred adults suffer from diagnosed or undiagnosed gluten intolerance, of which the majority are women. It is one of the most common chronic diseases in childhood, and can be contracted later in life as well. On a microscopic level it’s an inflammation in the small bowel triggered by gluten intake, but the root causes are not yet understood entirely. Following screening, a final diagnosis is made through a biopsy of the small bowel mucosa.
A gluten-free diet is the only treatment, avoiding wheat, barley, and rye products, however, patients can eat oats, according to Ludvigsson. Classical symptoms are growth failure and diarrhoea in children, and tiredness, diffuse gastrointestinal symptoms as well as osteoporosis, and an increased risk of certain cancers in adults. The disease is also linked to other autoimmune diseases such as type I diabetes and thyroid disease.
Previous studies showing a link between maternal gluten intolerance and the effect on babies had so far proved inconsistent. This study shows a more plausible mechanism – low placental weight – as well as showing the difference between treated and untreated patients. In addition, the statistical power in this study is greater, and the results have been adjusted for several other factors of importance.