Celiac Disease And Pregnancy

Celiac Disease has been found to be the cause of unexplained infertility in as many as four to eight percent of cases in women. But what can Celiac Disease mean for you when those two blue lines appear in the window and the doctor gives you the news you've been hoping for: "Congratulations. You're pregnant"?

There are potential risks associated with being a pregnant celiac, problems for both you and the foetus that it's impossible to ignore. However, with care, it is possible for a celiac woman to face the challenges presented by pregnancy, so that they can go on to have a healthy pregnancy and give birth to a healthy baby.

Problems Celiac Women face in Pregnancy

Women with untreated or poorly-managed Celiac Disease are more likely to suffer spontaneous miscarriage (both early and late-term), to give birth to a pre-term baby, to give birth to a low birth-weight baby, and have an increased likelihood of requiring a caesarean section.

So where's the proof?
A study of twenty-five celiac patients with sixty pregnancies found that 21% of women not following a strict gluten-free diet suffered miscarriage. A further 16% of the patients give birth to a baby with a low birth-weigh.

A large Danish study of 211 babies born to 127 mothers with poorly-managed Celiac Disease found that the babies were born with a lower birth-weight than babies born to mothers without Celiac Disease. As an aside, babies born to mothers with well-managed Celiac Disease were born at a heartier, heavier weight than babies born to non-celiac mothers.

Another study compared pregnant women with Celiac Disease following a gluten-free diet to women who did not, and found that celiac women who did not follow a gluten-free diet experienced a miscarriage-rate of 17.6%, compared to a miscarriage-rate of 2.4% in women who follow the gluten-free diet.

Why is this?

Malabsorption (where your body cannot absorb nutrients) and malnutrition (where your body lacks the nutrients it needs) are thought to be a partial cause of these pregnancy problems. In celiacs, this occurs due to the villi (the finger-like growths that line the intestine) becoming clogs. One particular pregnancy-supporting nutrient that celiacs often lack is Folate.

READ The Importance Of Folic Acid In Our Diet

How can I have a healthy celiac pregnancy?

The most important thing you can do is follow a strict gluten-free diet before, during, and after your pregnancy. Not following your gluten-free diet will lead to malabsorption and malnutrition, and may cause miscarriage. Added to which it could cause Folate-deficiency anaemia (causing tiredness, faintness, headaches, and muscle weakness); painful brittle bones (caused by vitamin D deficiency): and iron-deficiency anaemia (causing breathlessness and heart palpitations). These should be avoided at all times, but will place your body under particular strain while pregnant.

In addition to following a strict gluten-free diet, you should practice good nutrition. This may include taking supplements before and during your pregnancy. In our next section, we explore vital gestational supplements for pregnant celiacs.

Pregnant Celiacs And Supplements

Folic Acid

It is recommended that women take 400mcg of Folic Acid (the supplement form of Folate) for at least three months before pregnancy, and throughout pregnancy to prevent Spina Bifida. Although women with Celiac Disease are not specifically recommended to take any more, celiacs can be especially prone to getting Folate-deficiency anaemia. Before pregnancy, it might be worth having your levels checked (especially if you're feeling tired, weak, or are looking pale). If your levels are low, you may need to take up to 5mg of Folic Acid a day for a while to get them back to normal. This will increase your chances of a healthy pregnancy.

Make sure you also eat plenty of Folate-rich foods, such as beans and green, leafy veggies (such as asparagus, kale, and spinach).

Calcium and Vitamin D

Necessary for the development of strong, healthy bones. It is recommended that individuals with Celiac Disease take 1200mg of Calcium a day and 1000 IU of vitamin D. Celiacs may be lactose intolerant and may struggle to absorb vitamin D naturally, so it may be worth finding a suitable gluten-free supplement.

Make sure you take natural calcium, too. If you are lactose intolerant, use calcium-enriched milk-substitutes.

Omega-3 Fatty Acids

Omega-3 Fatty-Acids improve the development of the foetus' brain and nervous system, and should be included regularly in your pre-pregnancy and pregnancy diet. You should aim for up to 12 ounces of fish that is high in Omega-3 per week, particularly salmon, Pollock, shrimp, and light canned tuna (about two meals per week).

You should avoid fish that are high in Omega-3, but also high in mercury, such as: swordfish, shark, tilefish, and mackerel. Avoid these fish when preparing for pregnancy too, as mercury remains in your body for up to a year and can poison foetal development.

READ Should You Have Your Baby Screened For Genetic Diseases During Pregnancy?

Iron

Iron is necessary to make the extra blood you'll need for the baby. Make sure you get plenty of iron and vitamin C to boost iron-absorption. You need at least 27mg of iron a day. Having low-levels of iron can cause anaemia, resulting in your baby being premature (born too soon), or with a low birth-weight.

Also be sure to eat plenty of iron-rich food, including lentils, red-kidney beans, raisins, and lima beans.

Will this help?

There's evidence that sticking to a strict gluten-free diet can greatly improve outcomes for pregnant celiac women. Researchers found that women who had been pregnant more than once (whether or not they brought the child to term) experienced a 35.6% in miscarriage-rates, and a 29.4% reduction in the low birth-weight of their babies.

This can be partly-attributed to better absorption and nutrition, as a result of following a strict gluten-free diet.

A healthy diet, rich in necessary vitamins and minerals, and taking Folic Acid supplements has also been found to reduce the risk of miscarriage in all women, whether celiac or not (when the miscarriage is not caused by genetic abnormalities).

Hope for Celiac Women

Pregnancy never comes with any guarantees. But, by following a healthy strictly gluten-free diet and taking the correct vitamin supplements, there is hope that every celiac woman (even if she has suffered gluten-free complications in the past) can have a healthy pregnancy, and give birth to a healthy baby.