The link between undiagnosed celiac disease and adverse pregnancy outcomes: a growing concern
The connection between undiagnosed celiac disease and adverse pregnancy outcomes is a topic of increasing interest in the scientific community. Celiac disease, an autoimmune condition triggered by gluten ingestion in genetically predisposed individuals, if undiagnosed and improperly managed, can lead to complications during pregnancy, such as miscarriages, preterm birth, intrauterine growth restriction, and low birth weight. However, despite awareness of these risks, there remains a “gray area” regarding the optimal management of a gluten-free diet during conception, pregnancy, and breastfeeding.
Celiac disease and pregnancy: an ongoing challenge – the project
An international panel led by the IRCCS Ca’ Granda Foundation in Milan, in collaboration with the Mangiagalli Clinic, is working to address this gap. Its goal is to develop a pathway that ensures proper nutritional intake for women following a gluten-free diet during these delicate phases of life. The project is supported by the Anton Schär Foundation, which is committed to improving the quality of life for people with specific nutritional needs.
The importance of nutrition during pregnancy
Nutrition plays a crucial role in the journey toward pregnancy, influencing both maternal well-being and fetal development. Micronutrients such as iron, calcium, folic acid, omega-3 (DHA), and B vitamins are essential to prevent nutritional deficiencies, especially in women following a gluten-free diet. An unbalanced gluten-free diet or poor adherence can be associated with gestational issues, such as low birth weight or placental complications.
Gaps in current guidelines
Current guidelines primarily focus on celiac disease screening but do not provide specific recommendations on:
- Appropriate energy requirements.
- Recommended weight gain during pregnancy.
- Optimal distribution of micro- and macronutrients.
- Intake of vitamins and minerals, both from diet and supplements.
- The ideal timing for starting supplementation.
- Recommended portions of gluten-free foods for pregnant women with celiac disease.
The Need for Personalization
As highlighted by Dr. Luca Elli, head of the Center for Celiac Disease Prevention and Diagnosis at the Policlinico di Milano, following a gluten-free diet does not simply mean replacing traditional foods with gluten-free alternatives. It is necessary to redefine dietary and lifestyle habits to ensure proper nutritional and energy intake. The diet must be personalized based on clinical and individual needs, taking into account life stages with higher nutritional demands, such as pregnancy.
Optimizing the gluten-free diet
Professor Irene Cetin, Director of the Obstetrics Clinic at the Policlinico di Milano, emphasizes the importance of optimizing the gluten-free diet even during the pre-conception phase. This approach supports proper embryonic development and placentation, reducing inflammation levels that increase the risk of pregnancy-related pathologies. It is crucial to avoid excess saturated fats and sugars, often found in industrial gluten-free products.
The project’s key directions
This international panel is working on three main directives:
- Pre-conception Counseling: Women with celiac disease should receive nutritional counseling before conception to optimize their gluten-free diet and nutritional status.
- Monitoring and Support: Regular monitoring of nutritional status during pregnancy and breastfeeding is essential.
- Education: Providing educational materials on gluten-free nutrition and meal planning to support informed dietary choices.
The role of Anton Schär Foundation
The Anton Schär Foundation supports this project as part of its commitment to improving the lives of people with specific nutritional needs. Among its other initiatives:
- Funding a flow cytometer at Charité – University of Berlin for diagnosing refractory celiac disease.
- Creating research positions at the University of Applied Sciences Münster to study the ketogenic diet.
- Financing a research project at the University of Sheffield to investigate the inflammatory role of gliadins in non-celiac individuals.
This project represents a significant step toward more informed and personalized management of the gluten-free diet during pregnancy. Through collaboration among international experts and the support of organizations like the Anton Schär Foundation, the aim is to address a clinical gap and improve the quality of life for pregnant women with celiac disease, ensuring proper nutritional intake and reducing the risks of gestational complications.
For further information, you can contact the representatives of the Anton Schär Foundation or visit the website www.drschaer.com.
