I received this article today from Gluten-Free Works, I thought it would be a great article for those women who are trying to become pregnant to understand they don't have to be Celiac to suffer from gluten sensitivity and the many problems due to malabsorption.
Pregnancy Disorders, Celiac Disease and Gluten by John Libonati
Women around the world are following the gluten-free diet to increase the odds that they have a healthy pregnancy and delivery of a healthy baby. Considering that many complications can develop if nutrients are not being digested and absorbed properly during pregnancy due to celiac disease, it makes sense for women of child-bearing age in the United States (and anywhere else) to be screened.
Celiac disease is a hereditary, immune-mediated syndrome that is estimated to affect 1% of the human population (3 million in the US). Yet, less than 3% are estimated to be medically diagnosed, mainly due to healthcare provider ignorance. Celiac disease is only caused by the ingestion of wheat, barley, rye and oats and treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can often result in complete recovery. Although called a disease, the reaction to gluten is in fact a sensitivity and if these grains were never eaten by individuals whose immune systems react against gluten, no disease state would ever exist. Pregnancy is a factor that can activate or worsen the effects of celiac disease.
In celiac disease, a food protein called gluten, which is found in the grains of wheat, barley, rye and oats, triggers an immune attack in the small intestinal lining, causing inflammation and damage to its structures that absorb nutrients. When the section or sections that should absorb nutrients cannot function properly, nutrient deficits develop - even with prenatal vitamin/mineral supplementation. If nutrients in the forms of food and supplements are not absorbed, the body cannot access them and the developing baby does not have them available. Problems develop.
Nutrient deficiencies lead to breakdown and dysfunction in the body. They also lead to improper or incomplete development of the baby during pregnancy.
Here are some problems that can be experienced should a pregnant woman with undiagnosed celiac disease suffer from malabsorption of nutrients due to continued gluten consumption. Please note that not all these issues will develop. It may be only one, two or other problems altogether, depending on the nutrient(s) that are deficient.
· Spina bifida - from folic acid deficiency.
· Turner syndrome - from zinc deficiency
· Down syndrome - zinc deficiency is a contributing factor and prevalence of celiac disease among patients with Down syndrome is 10%.
· Congenital abnormalities - such as cleft lip and heart failure due to folic acid, iron, vitamin A or zinc deficiencies.
· Malformations, growth retardation, prematurity and perinatal death due to zinc deficiency.
Pregnancy & Post-pregnancy Complications
· Abnormally long or short gestations - can be due to folic acid, iron or zinc deficiency.
· Miscarriage/Spontaneous Abortion - a woman with celiac disease who eats gluten has an 8-900% greater likelihood of miscarriage. 15% miscarry. This can be due to folic acid, protein, vitamin A or zinc deficiency
· Abnormal taste - zinc deficiency.
· Increased maternal illness - slow healing, increased susceptibility to illness and infections, post partum pneumonia - all due to zinc deficiency.
· Intrauterine growth retardation - 30% reduction in baby's birth weight due to iron, omega-6 fatty acid, protein, vitamin A or zinc deficiency.
· Severe iron deficiency anemia - leading to risk of poor development of fetal organs, fatigue, pallor and susceptibility to infection.
· Abruptio placenta - partial or complete separation of the placenta from the uterine wall leading to hemorrhage of mother and fetal death - folic acid deficiency.
· Short duration of breast feeding - due to fat, calcium, phosphorous or protein absorption.
· Atonic bleeding after delivery - where the uterus fails to contract after delivery, or remain contracted and bleeding from the placenta site continues due to zinc deficiency.
These are just some of the problems that can develop due to nutrient deficiencies in pregnancy. If the mother is eating a nutritious diet and taking supplements - she or her baby can still experience one or more of these issues because her body does not absorb what she ingests if she has undiagnosed celiac disease and is eating gluten. Many more symptoms can be found in the book "Recognizing Celiac Disease" and are classified by nutrient deficiency or symptom name.
Women should be screened for celiac disease when they become pregnant or are trying to become pregnant. It is a simple case of benefit versus risk. There is no harm in testing the blood for celiac disease and gluten sensitivity at the same time other blood tests are being performed. The risk of not testing, should an undiagnosed woman continue to eat gluten and suffer malabsorption, includes various birth defects, miscarriage, death of the baby and injury to the mother.
If you experience any of the above problems during or after your pregnancy and your physician refuses or dismisses the idea of testing for celiac disease, please get a second opinion from a medical provider who is knowledgeable about celiac disease. The longer gluten is consumed, the greater will be its damaging effects on your body.
Finally, this article specifically deals with malabsorption of nutrients due to celiac disease. It is important to note that gluten can cause health problems by its own mechanism throughout the body, aside from celiac disease. Considering wheat, barley, rye and oats do not contain any nutrients that cannot be provided by other foods, we believe a gluten-free diet during pregnancy is a prudent course of action for any woman.