Background-Up to 50% of women with untreated coeliac disease experience mis
carriage or an unfavourable outcome of pregnancy. In most cases, after 6-12
months of a gluten free diet, no excess of unfavourable outcome of pregnan
cy is observed. The prevalence of undiagnosed coeliac disease among pregnan
t women is not known.
Aim-To determine the prevalence of untreated coeliac disease among women at
tending the obstetrics-gynaecological department.
Methods-Endomysial antibodies, which are specific and sensitive for coeliac
disease, were evaluated in all women attending the obstetrics-gynaecology
department of a large city hospital over a 90 day period.
Results-Of 845 pregnant screened, 12 were identified as having coeliac dise
ase. Three had previously been diagnosed but were not following a gluten fr
ee diet. The remaining nine underwent a small intestinal biopsy, which conf
irmed the diagnosis. The outcome of pregnancy was unfavourable in seven of
these 12 women. Six healthy babies were born with no problems after the wom
en had been on a gluten free diet for one year.
Conclusions-Overall, 1 in 70 women was affected by coeliac disease, either
not diagnosed (nine cases) or not treated (three cases). Their history of m
iscarriages, anaemia, low birth weight babies, and unfavourable outcome of
pregnancy suggests that testing for coeliac disease should be included in t
he battery of tests prescribed for pregnant women. Coeliac disease is consi
derably more common than most of the diseases for which pregnant women are
routinely screened. Unfavourable events associated with coeliac disease may
be prevented by a gluten free diet.