What to Know About Celiac Disease and Pregnancy

Celiac disease is an autoimmune disorder that causes an immune system reaction in response to consuming gluten, triggering white blood cells to attack the lining of the small intestine. When untreated, this can eventually cause the organ to erode.

The condition is associated with a host of potential complications in fertility, gestation, and postpartum life. This is particularly true for people who have the condition but haven’t been diagnosed, as well as those who live with the condition but do not follow a gluten-free diet.

Celiac Disease and Fertility

Research has shown that untreated or undiagnosed celiac disease is associated with increased infertility in people with a uterus. The prevalence of celiac disease may be as high as 4% to 8% in this population. The exact reasons for this remain unclear, however researchers do have some theories.

One such theory points to malnutrition. When you have celiac disease and do not treat it by following a gluten-free diet, malnutrition occurs because your autoimmune disease is causing your body to not absorb the nutrients it needs.

One study noted that the nutritional deficiencies seen in celiac disease can impair proper reproductive function. For example, one of the nutrients they looked at, selenium, is thought to be necessary for normal reproduction processes.

Deficiencies of selenium were linked with subfertility in people with celiac disease. Folic acid and icon deficiencies were also observed.

The researchers of this study admitted that while malnutrition may play a big role in infertility in people with celiac disease, it is most likely not the only cause. They thought that inflammation associated with the autoimmune response in celiac disease may also be to blame for issues with getting pregnant.

Celiac Disease Doctor Discussion Guide

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Higher Chance of Miscarriage

People with a uterus and undiagnosed celiac disease may be twice as likely to have repeat miscarriages compared to people who don’t have the condition.

Thankfully, data suggest that after adopting a gluten-free diet, many people with celiac disease who suffered miscarriages previously will be able to carry babies to term.

Celiac Disease and Gestation

Celiac disease is associated with some complications during pregnancy, such as shorter pregnancies on average as well as low birth weights. However, research is still inconsistent as to what this means overall, including whether celiac disease is the exact cause for these pregnancy issues.

Complications

Pregnancy complications associated with celiac disease include:

• Severe anemia
• Pregnancy-related hypertension (high blood pressure)
• Uterine hyperkinesia
• Intrauterine growth restriction

In addition to those complications, people with celiac disease were also found to have shorter pregnancies and babies with low birth weights. This low birth weight may be the result of the shorter time being pregnant.

Treatment

In one study, around 85% of people had not been previously diagnosed with celiac disease at the time of their pregnancies. The researchers suggested that a gluten-free diet may help prevent or treat their pregnancy complications.

A gluten-free diet is an elimination diet, removing all traces of gluten from one’s meals. Eating a gluten-free diet when you have celiac disease can help alleviate symptoms and repair intestinal damage.

Gluten appears naturally in certain grains, including:

• Various types of wheat (durum, emmer, semolina, and spelt)
• Barley
• Rye
• Triticale (a cross between wheat and rye)

Some ingredients and additives found in foods also contain gluten. This is especially true in processed foods.

This is why it is important to carefully read the labels of what you are consuming to ensure it is truly gluten-free. You should also be mindful of cross-contamination, especially when dining out and preparing foods.

Concerning Symptoms

Some people with celiac disease have symptoms that affect other parts of the body. These symptoms may include:

• Dermatitis herpetiformis
• Fatigue, or feeling tired
• Joint or bone pain
• Mental health problems, such as depression
• Nervous system symptoms, such as headaches, balance problems, seizures, or peripheral neuropathy
• Symptoms involving the mouth, such as canker sores 
  

Celiac Disease and Postpartum

There are no studies that suggest that celiac disease makes recovery from labor and delivery any more difficult. However, celiac disease can potentially affect breastfeeding.

Breastfeeding

Celiac disease can affect the composition of breast milk in nursing parents. One study saw that breast milk from the nursing parent had a lower amount of immunoprotective compounds (TGF-β1 and sIgA) and bifidobacteria if they had celiac disease.

The researchers of this study theorized that these lowered levels could diminish the protective benefits of breastfeeding, which would raise the child’s risk for developing celiac disease later on.

However, it should be noted that this study had a small sample size of only 12 mothers. Still, the findings are interesting and worth considering.

Summary

People with undiagnosed and untreated celiac disease may have trouble getting pregnant. However, if your celiac disease is managed with a gluten-free diet, you should not experience issues while trying to conceive.

This condition has been associated with some pregnancy complications such as low birth weight and severe anemia. Again, keeping your condition under control can help minimize your risk of developing these issues.

Celiac disease should not affect your postpartum recovery, but limited evidence has shown that it may have an impact on breastfeeding.

A Word From Verywell

It’s important to keep in mind that proper treatment of your illness can help mitigate any adverse effects. It is also important to know that research in this area is still rather limited overall.

The research that is available is inconsistent. Some people with celiac disease do go on to get pregnant and go through pregnancy without complications.

If you have concerns about celiac disease and pregnancy, talk to your doctor. They can help develop an appropriate treatment plan and diet for you.

Frequently Asked Questions

What are the risks of getting pregnant when you have celiac disease?

Pregnancy complications associated with celiac disease include miscarriage, shorter pregnancies, and babies with a low birth weight. Proper treatment for the condition such as following a gluten-free diet is vital to reducing one’s risk of developing these complications during pregnancy.

How much folic acid should you take when you’re trying to get pregnant if you have celiac disease?

If you have celiac disease and are trying to get pregnant, it is recommended to take 5 mg of folic acid daily. People trying to get pregnant with celiac disease should also carefully follow a gluten-free diet. Those with undiagnosed or untreated celiac are more likely to experience fertility issues, suggesting that adhering to a gluten-free diet helps with fertility in those with celiac disease.

What type of doctor should I see if I have celiac disease and am trying to get pregnant?

You should see your OB-GYN, as well as your gastroenterologist. They should work as a team to help you on your journey to getting pregnant. Be sure to ask them any questions you may have—it’s what they’re there for.