Maternal diet plays a critical role in fetal development. When a woman has undiagnosed or untreated celiac disease, gluten exposure may have measurable effects on pregnancy outcomes. [click here to read about celiac disease and pregnancy]. It is worth testing for celiac disease if you are considering getting pregnant.
A large population-based study published in Human Reproduction (2010;25(2):528–534) analyzed more than 1.5 million births. Infants born to women with untreated celiac disease had lower birth weights, a higher risk of being very small for gestational age, and an increased risk of preterm delivery compared with infants born to women whose celiac disease had been diagnosed and treated with a gluten-free diet.
Similar findings were reported in a national cohort study published in Gastroenterology (2005;129(2):454–463). Undiagnosed maternal celiac disease was associated with intrauterine growth restriction, low birth weight, preterm birth, and increased rates of Caesarean section, while women diagnosed before pregnancy did not show these elevated risks.
There may also be longer-term neurodevelopmental implications. A study published in American Journal of Psychiatry (2012;169(6)) found that elevated maternal antibodies to gliadin (a gluten protein), measured in neonatal blood spots, were associated with an increased risk of nonaffective psychotic disorders later in life. Antibodies to casein (a milk protein) were not associated with this risk.
Taken together, these findings suggest that undiagnosed maternal gluten sensitivity—rather than celiac disease itself—may contribute to adverse pregnancy and developmental outcomes, underscoring the importance of appropriate screening in women with unexplained gastrointestinal or nutritional issues before or during pregnancy.
