Retrospective evaluation of pregnant women with celiac disease

Abstract

Objective:To show celiac disease (CD) and its poor pregnancy outcome relationship, and to demonstrate the importance of a gluten-free diet together with low-dose low-molecular-weight heparin (LMWH) and low-dose corticosteroid (LDC) in the management of pregnancies with CD.Material and Methods:This study consisted of 2 groups of patients. Six patients with CD (control group) on a gluten-free diet were monitored during their first pregnancies within the framework of antenatal care program and their pregnancy outcomes were compared with eight poorly-treated pregnant patients with CD (study group) who were referred from other medical institutions. LMWH (enoxaparine 1x2000 Anti-XA IU/0.2 mL/day), and LDC (methylprednisolone 1x4 mg p.o/day) were used in the control group. Their obstetric histories and outcomes of their last pregnancies were compared. The patients’ obstetric risk levels were evaluated using the “Beksac Obstetrics Index” (BOI).Results:There were miscarriages in 50% of the study group. There were also 50% and 75% preterm deliveries in the control and study groups, respectively. The BOI of the study group was significantly worse than the control group (1.31 vs. 0.31±0.21, p<0.01). There were no statistically significant differences between age (24±4.7 vs 31.7±6 years, p=0.448), gestational day of birth (259.3±8.5 vs 246.6±24.3), birthweight (2691±698 vs 2262±359 g, p=0.394), and cesarean section rates (p=0.118).Conclusion:CD is a risk factor for adverse pregnancy outcome. Miscarriage and preterm labor are critical complications in pregnancies complicated by CD. A gluten-free diet is important in the treatment. LMWH and LDC seem to be helpful in the management of pregnant women with CD.

Chorionic villus sampling experience of a reference perinatal medicine center

“…This finding is something expected because of the inheritance of the disorders. This index has been previously used in literature for comparison of high-risk pregnancy groups (Beksaç et al, 2017;Fadiloglu, Unal, & Beksac, 2018b).…”

Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies

“…), which may cause impaired fetal perfusion and result in fetal death (17). Adverse outcomes were reported in autoimmune diseases such as Behcet disease, Celiac disease, inflammatory bowel diseases, Systemic lupus erythematosus (SLE) and Hashimoto's thyroiditis (18)(19)(20)(21). MTHFR polymorphisms are also related to poor perinatal outcome and necessitate special antenatal care (12,22).…”

Retrospective evaluation of pregnancies with ankylosing spondylitis in a tertiary center in Turkey

“…Requirement for medical treatment including biological agents was also found to contribute to poor obstetric outcomes . Excessive activation of the immune system may lead to impaired implantation and impaired fetal perfusion, which is also related to poor obstetric outcomes . Autoimmune antibodies, cell degradation products and inflammatory cytokines were reported to be responsible for injury to vascular structures of the placenta and cellular components of the maternal fetal interface, resulting in “placental inflammation” .…”

“…Excessive activation of the immune system may lead to impaired implantation and impaired fetal perfusion, which is also related to poor obstetric outcomes . Autoimmune antibodies, cell degradation products and inflammatory cytokines were reported to be responsible for injury to vascular structures of the placenta and cellular components of the maternal fetal interface, resulting in “placental inflammation” . Thus, pregnancies of women with AS may also require greater attention in terms of both obstetric and neonatal outcomes.…”