The Department of Obstetrics and Gynecology, University of Utah, Utah 30 North 1900 East #2B200, Salt Lake City, UT 84132, USA.
J Reprod Immunol. 2013 Dec;100(2):104-8. doi: 10.1016/j.jri.2013.09.006. Epub 2013 Oct 14.
Celiac disease has been associated with numerous unfavorable health outcomes, including pregnancy complications such as infertility, preterm birth, and preeclampsia. However, the association between celiac disease and recurrent pregnancy loss (RPL) remains uncertain. Our purpose was to compare serum markers of celiac disease in women with and without RPL. Therefore, we performed a case-control study of 116 women with unexplained recurrent pregnancy loss and 116 age-matched controls. Maternal sera were analyzed for immunoglobulin A (IgA) and immunoglobulin G (IgG) tissue transglutaminase (tTG) antibodies and endomysial (EM) antibodies. Groups were similar with regard to age, race and ethnicity, and BMI. One case and one control tested positive (≥20 Units) for IgA tTG antibodies and mean levels of IgA tTG antibodies were similar in cases and controls (5.5±2.86 versus 6.0±12.45; p=0.16). No cases or controls were positive for IgG tTG antibodies. However, cases had higher levels of IgG tTG antibody compared with controls (4.0±2.40 versus 3.3±1.30; p=0.0064). One subject (a control) tested positive for IgA EM antibodies and no subjects tested positive for IgG EM antibodies. In conclusion, positive results for tTG and EM antibodies were similar in women with and without RPL. Given these results, testing for occult celiac disease is not recommended in the evaluation of women with idiopathic RPL.
乳糜泻与许多不良健康后果有关,包括不孕、早产和子痫前期等妊娠并发症。然而,乳糜泻与复发性妊娠丢失(RPL)之间的关联仍不确定。我们的目的是比较有和无 RPL 的女性中乳糜泻的血清标志物。因此,我们对 116 例原因不明的复发性妊娠丢失女性和 116 名年龄匹配的对照组进行了病例对照研究。分析了母体血清中的免疫球蛋白 A(IgA)和免疫球蛋白 G(IgG)组织转谷氨酰胺酶(tTG)抗体和内肌膜(EM)抗体。两组在年龄、种族和民族以及 BMI 方面相似。1 例病例和 1 例对照的 IgA tTG 抗体检测呈阳性(≥20 单位),病例和对照组的 IgA tTG 抗体平均水平相似(5.5±2.86 与 6.0±12.45;p=0.16)。无病例或对照 IgG tTG 抗体阳性。然而,病例的 IgG tTG 抗体水平高于对照组(4.0±2.40 与 3.3±1.30;p=0.0064)。1 例(对照)对 IgA EM 抗体检测呈阳性,无 IgG EM 抗体检测呈阳性。总之,RPL 妇女和无 RPL 妇女的 tTG 和 EM 抗体阳性结果相似。鉴于这些结果,不建议在评估特发性 RPL 妇女时进行隐匿性乳糜泻检测。