Латентная целиакия - еще одна причина повторного невынашивания (недавние публикации)

[Dr.Vad]

The prevalence of positive antibodies for subclinical celiac disease (CD) in RPL versus controls (taking patients with at least two positive tests) was 3.51% versus 0.0% (P < 0.04). The condition of all these patients is silent from the gastrointestinal viewpoint, however this condition can be the cause of an unfavorable outcome of pregnancy.

The CD is an autoimmune disorder associated with the production of an autoantibody against transglutaminase which is present in human tissue. Early expression of anti-endomysium is observed in the cultured small intestinal mucosa of patients with celiac disease exposed to gliadin.

Women with undiagnosed celiac disease seem to have an 8.9-fold relative risk of multiple abortions and low birth weight babies compared with treated patients.

A gluten free diet resulted in a 9.18-fold reduction in the abortion rate and a reduction in the prevalence of low birth weight babies from 29.4% to zero. In another study, 15% of 68 women with untreated CD had miscarriages compared with 6% of controls, but after a gluten free diet, the miscarriage rate was similar in patients and controls.

Autoantibodies in Argentine women with recurrent pregnancy loss RPL.
Bustos D, Moret A, Tambutti M, Gogorza S, Testa R, Ascione A, Prigoshin N.
Am J Reprod Immunol. 2006 Mar;55(3):201-7.

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Celiac disease (CD) is a permanent intolerance to gluten characterized by destructions of the small intestinal villi and malabsorption. The gluten-free diet (GFD) results in healing of the mucosa, resolution of the malabsorpitive states, and reversal of great part of CD effects. Among the extradigestive complications associated with CD, unexplained infertility has been reported since the 70's. The prevalence of CD among women with unexplained infertility is 2.5-3.5%, higher, although not always significantly, than control population. To date, it is widely accepted that untreated CD represents a risk for abortion, low birth weight babies and short-breast feeding period. These features can be corrected by GFD. Some discrepancies could stem from the heterogeneity of the studies. In conclusion, each woman with unexplained infertility should be screened for CD.

Minerva Med. 2007 Jun;98(3):217-9.
Women and celiac disease: association with unexplained infertility.
Pellicano R, Astegiano M, Bruno M, Fagoonee S, Rizzetto M.

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A case-control study about the effect of GFD on pregnancy was conducted from 1995 to 2006. A cohort of 13 women (mean age 32 years, range 22-38 years) affected by CD with recurrent miscarriages was observed. In all of them several causes of miscarriage (gynecological, endocrine, hematological, etc.) were excluded. All patients were started on a gluten-free diet and were reassessed throughout a long-term follow-up period to evaluate the outcome of pregnancy. RESULTS: Six of 13 became pregnant (46.15%) as follows: 1 patient (7.69%) 1 year after GFD was started, 3 patients (23.07%) 2 years after GFD was started, 1 patient (7.69%) after 3 years, and finally 1 (7.69%) 4 years after GFD was started. Moreover, two patients (16.66%) had multiple pregnancies (one had had two childbirths and another had undergone three births within a 7-year follow-up period under GFD).

Effect of gluten-free diet on pregnancy outcome in celiac disease patients with recurrent miscarriages.
Tursi A, Giorgetti G, Brandimarte G, Elisei W.
Dig Dis Sci. 2008 Nov;53(11):2925-8.