Using a population-based study of 7046 singleton pregnancies (from the Netherlands), the authors of a recent study have shown an inverse relationship between levels of anti-tissue transglutaminase IgA (TTG) antibodies and fetal growth (Gastroenterol 2013; 144: 726-35).
- Newborns of positive TTG (>6 U/mL) weighed 159 g less at birth than newborns of mothers who tested negative for TTG. In addition, newborns with mothers who had intermediate TTG levels ( 0.8 U/mL to 6 U/mL) had growth restriction of 53 g.
- Among the intermediate TTG group, the results were more pronounced (2-fold greater) in those carrying the HLA risk molecules for celiac disease.
- These birth weight changes were not associated with maternal nutritional status or deficiencies related to hemoglobin, iron, folate, or vitamin B12 deficiency.
- Gestational age was not affected by TTG titers.
In the discussion, the authors note that other studies have shown that undiagnosed celiac disease increases the risk for intrauterine growth retardation; this risk can be eliminated by treating celiac disease. The latter is a risk factor for lower neuropsychological performance. This study was the first that took into effect the different TTG titers and correlated with additional nutritional parameters.
The authors speculate that celiac disease could have direct effects on the placenta. In addition, other nutritional parameters could play a role such as vitamin D and calcium which were not included in this study. Another important consideration is that celiac disease can result in increased miscarriages. As a result, the “true” effect on newborn growth may be underestimated due to a “survivor bias.”
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