Maternal, obstetrical, and neonatal outcomes in celiac disease

Abstract

Objectives

Some studies have suggested a link between celiac disease (CD) and adverse maternal, obstetrical, and neonatal outcomes. Using a large database, we evaluated the effect of CD on pregnancy outcomes.

Methods

We conducted a retrospective cohort study using the National Inpatient Sample (NIS) of all deliveries from 2015 to 2019 in the United States. Using ICD-10 codes, we identified pregnant patients who had CD and those who did not. A multivariate logistic regression was used to generate odds ratios (ORs) with 95% confidence intervals (CIs) for maternal, obstetrical, and neonatal outcomes.

Results

Of 12,039,222 deliveries between 2015 and 2019, there were 10,555 births in women with CD. Pregnant women with CD were more likely to be white and older compared to those without CD. Pregnant women with CD were significantly more likely to carry a diagnosis of gestational hypertension (OR 1.26; 95% CI 1.04–1.52), preeclampsia (1.28; 1.08–1.53), and severe preeclampsia (1.62; 1.25–2.09). They were less likely to have a full-term uncomplicated delivery (OR 0.11; 95% CI, 0.05–0.20), while being more likely to require device-assisted delivery (1.25; 1.04–1.50) and sustain 3rd or 4th degree vaginal lacerations (1.56; 1.21–2.02). Babies of pregnant women with CD were more likely to be small for gestational age (SGA) (OR 1.29; 95% CI 1.03–1.61).

Conclusions

CD in pregnancy appears to be associated with increased adverse maternal, obstetrical, and neonatal outcomes. Clinicians should discuss these increased risks with CD patients who are planning to conceive.

Keywords:

• Enteropathy
• maternal health
• obstetric
• childbirth
• women’s health

Author contributions

Khaled Alsabbagh Alchirazi and Yazan Abu-Omar were involved in designing the study protocol and data collection tool. Yazan Abu-Omar and Khaled Alsabbagh Alchirazi were involved in data collection. Yazan Abu-Omar was involved with generation of matched cohort. Yazan Abu-Omar and Thebet Qapaja were responsible for data analysis. Mohammad Aldiabat, Khaled Alsabbagh Alchirazi, Osama Abu-Shawer, Osama Hamid, Thabet Qapaja, Ahmed Eltelbany, and Claire Jansson-Knodell were responsible for the first manuscript draft. Alberto Rubio-Tapia is the guarantor of the article. All authors contributed to reviewing and editing the manuscript. All authors contributed to the final draft and approved this submission.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

None directly for the study. Claire Jansson-Knodell is supported by AGA Research Foundation’s AGA-Takeda Pharmaceuticals Research Scholar Award in Celiac Disease – AGA2022-13-07.