Anu Research Centre, Department of Obstetrics and Gynecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland.
Hum Reprod. 2010 Feb;25(2):528-34. doi: 10.1093/humrep/dep409. Epub 2009 Nov 24.
Adverse pregnancy outcomes have been associated with maternal celiac disease (CD). In this study, we investigate the effect of treated and untreated maternal CD on infant birthweight and preterm birth.
A population-based cohort study consisted of all singleton live births in Denmark between 1 January 1979 and 31 December 2004 was used. A total of 1,504,342 babies were born to 836,241 mothers during the study period. Of those, 1105 babies were born to women with diagnosed CD and 346 were born to women with undiagnosed CD. Women with diagnosed CD were considered as treated with a gluten free diet while women with undiagnosed CD were considered as untreated. The outcome measures were: birthweight, small for gestational age (SGA: birthweight <10th centile), very small for gestational age (VSGA: birthweight <5th centile) and preterm birth. We compared these measures in treated and untreated women with those of a reference group (no history of CD).
Women with untreated CD delivered smaller babies [difference = -98 g (95% CI: -130, -67)], with a higher risk of SGA infants [OR = 1.31 (95% CI: 1.06, 1.63)], VSGA infants [OR = 1.54 (95% CI: 1.17, 2.03)] and preterm birth [OR = 1.33 (95% CI: 1.02, 1.72)] compared with women without CD. Women with treated CD had no increased risk of reduced mean birthweight, risk of delivering SGA and VSGA infants or preterm birth compared with women without CD.
Untreated maternal CD increases the risk of reduced birthweight, the risk of delivering SGA and VSGA infants and preterm birth. Diagnosis and presumed treatment of maternal CD with a gluten-free diet appeared to result in a birthweight and preterm birth rate similar to those in women without CD.
不良妊娠结局与母体乳糜泻（CD）有关。本研究旨在探讨治疗和未治疗的母体 CD 对婴儿出生体重和早产的影响。
本研究使用了一项基于人群的队列研究，该研究纳入了 1979 年 1 月 1 日至 2004 年 12 月 31 日期间丹麦所有单胎活产儿。在研究期间，共有 1504342 名婴儿出生在 836241 名母亲中。其中，1105 名婴儿出生在确诊 CD 的母亲中，346 名婴儿出生在未确诊 CD 的母亲中。患有确诊 CD 的女性被认为接受了无麸质饮食治疗，而患有未确诊 CD 的女性则被认为未接受治疗。结局指标为出生体重、小于胎龄儿（SGA：出生体重 <第 10 百分位数）、极小于胎龄儿（VSGA：出生体重 <第 5 百分位数）和早产。我们将这些指标与未患 CD 的妇女的指标进行比较。
未治疗的 CD 女性所生婴儿体重较小[差值=-98g（95%CI：-130，-67）]，SGA 婴儿的风险较高[OR=1.31（95%CI：1.06，1.63）]，VSGA 婴儿的风险较高[OR=1.54（95%CI：1.17，2.03）]，早产的风险较高[OR=1.33（95%CI：1.02，1.72）]。与未患 CD 的妇女相比，接受治疗的 CD 女性出生体重降低、SGA 和 VSGA 婴儿或早产的风险没有增加。
未治疗的母体 CD 增加了出生体重降低、SGA 和 VSGA 婴儿以及早产的风险。对母体 CD 进行诊断和假定的无麸质饮食治疗似乎导致出生体重和早产率与未患 CD 的妇女相似。
