Observation
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World J Gastroenterol. Dec 14, 2010; 16(46): 5810-5814
Published online Dec 14, 2010. doi: 10.3748/wjg.v16.i46.5810
Reproductive changes associated with celiac disease
Hugh James Freeman
Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 1W5, Canada
Author contributions: Freeman HJ contributed wholly to this paper.
Correspondence to: Hugh James Freeman, MD, CM, FRCPC, FACP, Department of Medicine (Gastroenterology), University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC, V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: August 14, 2010
Revised: October 26, 2010
Accepted: November 3, 2010
Published online: December 14, 2010
Abstract

Celiac disease is a mucosal disorder of the small intestine that may be triggered by dietary exposure to gluten in genetically-susceptible individuals. The disorder is often associated with diarrhea, malabsorption and weight loss along with other extra-intestinal complications. Reproductive changes have been described, including impaired fertility and adverse pregnancy outcomes possibly related to immune-mediated mechanisms or nutrient deficiency. Other possible pathogenetic factors that may alter placental function include maternal celiac disease autoantibodies binding to placental transglutaminase, and genetic mutations that may facilitate microthrombus formation. Reports noting activation during pregnancy or the puerperium may be important, and suggest that celiac disease may also be hypothetically precipitated by maternal exposure to one or more fetal antigens.

Keywords: Celiac disease; Infertility; Pregnancy; Postpartum celiac disease; Fetal outcome