Adverse pregnancy outcomes in women with celiac disease: a systematic review and meta-analysis

Arvanitakis, Konstantinos; Siargkas, Antonios; Dagklis, Themistoklis; Tsakiridis, Ioannis

doi:10.20524/aog.2022.0764

Cited by 4 publications

(3 citation statements)

References 50 publications

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“…The presence of such risk factors warrants increased surveillance for the development of FGR, as several studies have proved their strong association with this pregnancy complication. [24][25][26][27][28][29] A French study of 14,100 births concluded that screening specificity and antenatal identification of FGR are improved when maternal and pregnancy risk factors are investigated. 30 According to the reviewed guidelines, the risk assessment should be universal and undertaken preconceptionally (PSANZ), at early pregnancy booking (RCOG, PSANZ, and RCPI), and at each antenatal visit (PSANZ).…”

Section: Risk Stratificationmentioning

confidence: 99%

“…Thus, all medical societies (except SMFM, ISUOG, and FCGO, which make no relevant reference) highlight the importance of a detailed medical, obstetric, and family history, to identify risk factors that may lead to suboptimal fetal growth in utero, such as advanced maternal age and high body mass index, nulliparity, low socioeconomic status, previous history of stillbirth, preterm delivery or SGA, smoking, drug misuse, previous history of hypertensive disorders of pregnancy, and chronic maternal diseases. The presence of such risk factors warrants increased surveillance for the development of FGR, as several studies have proved their strong association with this pregnancy complication 24–29 . A French study of 14,100 births concluded that screening specificity and antenatal identification of FGR are improved when maternal and pregnancy risk factors are investigated 30 .…”

Section: Risk Stratificationmentioning

confidence: 99%

See 1 more Smart Citation

Fetal Growth Restriction: A Comprehensive Review of Major Guidelines

Giouleka,

Tsakiridis,

Mamopoulos

et al. 2023

Obstetrical &Amp; Gynecological Survey

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Importance Fetal growth restriction (FGR) is a common pregnancy complication and a significant contributor of fetal and neonatal morbidity and mortality, mainly due to the lack of effective screening, prevention, and management policies. Objective The aim of this study was to review and compare the most recently published influential guidelines on the management of pregnancies complicated by FGR. Evidence Acquisition A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the International Society of Ultrasound in Obstetrics and Gynecology, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada (SOGC), the Perinatal Society of Australia and New Zealand, the Royal College of Physicians of Ireland, the French College of Gynecologists and Obstetricians (FCGO), and the German Society of Gynecology and Obstetrics on FGR was carried out. Results Several discrepancies were identified regarding the definition of FGR and small-for-gestational-age fetuses, the diagnostic criteria, and the need of testing for congenital infections. On the contrary, there is an overall agreement among the reviewed guidelines regarding the importance of early universal risk stratification for FGR to accordingly modify the surveillance protocols. Low-risk pregnancies should unanimously be evaluated by serial symphysis fundal height measurement, whereas the high-risk ones warrant increased sonographic surveillance. Following FGR diagnosis, all medical societies agree that umbilical artery Doppler assessment is required to further guide management, whereas amniotic fluid volume evaluation is also recommended by the ACOG, the SOGC, the Perinatal Society of Australia and New Zealand, the FCGO, and the German Society of Gynecology and Obstetrics. In case of early, severe FGR or FGR accompanied by structural abnormalities, the ACOG, the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the Royal College of Obstetricians and Gynecologists, the SOGC, and the FCGO support the performance of prenatal diagnostic testing. Consistent protocols also exist on the optimal timing and mode of delivery, the importance of continuous fetal heart rate monitoring during labor, and the need for histopathological examination of the placenta after delivery. On the other hand, guidelines concerning the frequency of fetal growth and Doppler velocimetry evaluation lack uniformity, although most of the reviewed medical societies recommend an average interval of 2 weeks, reduced to weekly or less when umbilical artery abnormalities are detected. Moreover, there is a discrepancy on the appropriate timing for corticosteroids and magnesium sulfate administration, as well as the administration of aspirin as a preventive measure. Cessation of smoking, alcohol consumption, and illicit drug use are proposed as preventive measures to reduce the incidence of FGR. Conclusions Fetal growth restriction is a clinical entity associated with numerous adverse antenatal and postnatal events, but currently, it has no definitive cure apart from delivery. Thus, the development of uniform international protocols for the early recognition, the adequate surveillance, and the optimal management of growth-restricted fetuses seem of paramount importance to safely guide clinical practice, thereby improving perinatal outcomes of such pregnancies. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After participating in this activity, the learner should be better able to define fetal growth restriction; describe screening and preventive recommendations for fetal growth restriction; and explain antenatal and intrapartum management options for pregnancies complicated by fetal growth restriction.

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Section: Risk Stratificationmentioning

confidence: 99%

Section: Risk Stratificationmentioning

confidence: 99%

Fetal Growth Restriction: A Comprehensive Review of Major Guidelines

Giouleka,

Tsakiridis,

Mamopoulos

et al. 2023

Obstetrical &Amp; Gynecological Survey

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“…2 Adverse pregnancy outcomes, including intrauterine fetal growth restriction, stillbirth, spontaneous abortion, preterm delivery, cesarean delivery, and low mean birthweight, are well described in pregnant women with undiagnosed CD. 3 However, CD rarely presents during pregnancy, and few cases of fulminant CD, or celiac crisis, have been reported during the postpartum period. [4][5][6] We report a case of celiac crisis with a life-threatening presentation postpartum.…”

Section: Introductionmentioning

confidence: 99%

Fulminant Celiac Disease Presenting in the Postpartum Period

Kuwelker,

Soni,

Perez-Sanchez

et al. 2024

ACG Case Rep J

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Celiac disease (CD) is an immune-mediated disorder of the small intestine triggered by dietary exposure to gluten in genetically susceptible individuals. Adult CD usually has an insidious onset with gastrointestinal symptoms, most often diarrhea and weight loss. The association between CD and reproductive abnormalities has been well described in the literature, but it is uncommon for CD to initially manifest during pregnancy or the postpartum period. We report a case of adult CD in a previously healthy woman with a life-threatening presentation during the postpartum period.

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