The impact of celiac disease on the gestational process
DOI:
https://doi.org/10.33448/rsd-v14i6.49064Keywords:
Celiac Disease, Pregnancy, Diet, Gluten-Free, Obstetric Labor, Premature, Infertility.Abstract
This article aims to examine how celiac disease affects women of childbearing age, including those who are pregnant or trying to become pregnant, with a focus on obstetric risks, nutritional deficiencies and management approaches. A descriptive bibliographic review, based on articles published between 2015 and 2025 in the PubMed, SciELO, LILACS and Cochrane Library databases. We used the descriptors “celiac disease”, “gestation” and “gluten-free diet” to identify relevant jobs. The results indicate that untreated celiac disease is associated with infertility, spontaneous abortions, premature birth and low birth weight. Furthermore, significant nutritional deficiencies were observed, such as iron deficiency anemia, hypocalcemia and insufficient levels of vitamin D. An analysis demonstrated that a rigorous addition to a gluten-free diet significantly reduces maternal and fetal complications, improving nutritional parameters and obstetric defects. It is concluded that early diagnosis, combined with multidisciplinary support and nutritional education, is crucial to minimize risks and promote healthy pregnancy in celiac patients. It highlights the need for standardized clinical protocols and psychosocial support during the prenatal period, as well as new research to optimize management guidelines.
References
Abu-Freha, N., Wainstock, T., Philip, A., & Sheiner, E. (2021). Maternal celiac disease and the risk for long-term infectious morbidity of the offspring. American Journal of Reproductive Immunology, 86(1). https://doi.org/10.1111/AJI.13399
Arcieri, M., Abrami, C., Graziano, A., Restaino, S., Barbui, E., Rizzante, E., D’Ippolito, S., Vizzielli, G., & Driul, L. (2024). The influence of celiac disease on fertility and pregnancy: an Italian survey. Archives of Gynecology and Obstetrics, 310(6), 2907–2914. https://doi.org/10.1007/S00404-024-07781-Y
Bhatia, Z., Kumar, S., & Seshadri, S. (2024). Composition and interaction of maternal microbiota with immune mediators during pregnancy and their outcome: A narrative review. Life Sciences, 340. https://doi.org/10.1016/J.LFS.2024.122440
Calatayud, M., Koren, O., & Collado, M. C. (2019). Maternal Microbiome and Metabolic Health Program Microbiome Development and Health of the Offspring. Trends in Endocrinology and Metabolism, 30(10), 735–744. https://doi.org/10.1016/J.TEM.2019.07.021
Camacho-Morales, A., Caba, M., García-Juárez, M., Caba-Flores, M. D., Viveros-Contreras, R., & Martínez-Valenzuela, C. (2021). Breastfeeding Contributes to Physiological Immune Programming in the Newborn. Frontiers in Pediatrics, 9. https://doi.org/10.3389/FPED.2021.744104
Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health, 10(5). https://periodicos.ufpel.edu.br/index.php/enfermagem/article/view/19924
Catassi, C., Bai, J. C., Bonaz, B., Bouma, G., Calabrò, A., Carroccio, A., Castillejo, G., Ciacci, C., Cristofori, F., Dolinsek, J., Francavilla, R., Elli, L., Green, P., Holtmeier, W., Koehler, P., Koletzko, S., Meinhold, C., Sanders, D., Schumann, M., … Fasano, A. (2013). Non-celiac gluten sensitivity: The new frontier of gluten related disorders. Nutrients, 5(10), 3839–3853. https://doi.org/10.3390/NU5103839
Ciacci, C., Cirillo, M., Auriemma, G., Di Dato, G., Sabbatini, F., & Mazzacca, G. (1996). Celiac Disease and Pregnancy Outcome. Obstetrical & Gynecological Survey, 51(11), 643–644. https://doi.org/10.1097/00006254-199611000-00003
Corrao, G., Corazza, G. R., Bagnardi, V., Brusco, G., Ciacci, C., Cottone, M., Sategna Guidetti, C., Usai, P., Cesari, P., Pelli, M. A., Loperfido, S., Volta, U., Calabró, A., & Certo, M. (2001). Mortality in patients with coeliac disease and their relatives: A cohort study. Lancet, 358(9279), 356–361. https://doi.org/10.1016/S0140-6736(01)05554-4
Dominguez-Bello, M. G., Costello, E. K., Contreras, M., Magris, M., Hidalgo, G., Fierer, N., & Knight, R. (2010). Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proceedings of the National Academy of Sciences of the United States of America, 107(26), 11971–11975. https://doi.org/10.1073/PNAS.1002601107
Eliakim, R., & Sherer, D. M. (2001). Celiac disease: Fertility and pregnancy. Gynecologic and Obstetric Investigation, 51(1), 3–7. https://doi.org/10.1159/000052881
Fasano, A., & Catassi, C. (2012). Celiac Disease. New England Journal of Medicine, 367(25), 2419–2426. https://doi.org/10.1056/NEJMCP1113994
France, A., & Penmetsa, A. (2024). A Review of Celiac Disease and Its Implications on Fertility and Pregnancy. Seminars in Reproductive Medicine, 42(3), 193–196. https://doi.org/10.1055/S-0044-1791703
Green, P. H. R., & Cellier, C. (2007). Medical progress: Celiac disease. New England Journal of Medicine, 357(17). https://doi.org/10.1056/NEJMRA071600
Husso, A., Pessa-Morikawa, T., Koistinen, V. M., Kärkkäinen, O., Kwon, H. N., Lahti, L., Iivanainen, A., Hanhineva, K., & Niku, M. (2023). Impacts of maternal microbiota and microbial metabolites on fetal intestine, brain, and placenta. BMC Biology, 21(1). https://doi.org/10.1186/S12915-023-01709-9
Ignacio, A., Czyz, S., & McCoy, K. D. (2024). Early life microbiome influences on development of the mucosal innate immune system. Seminars in Immunology, 73. https://doi.org/10.1016/J.SMIM.2024.101885
Jašarević, E., & Bale, T. L. (2019). Prenatal and postnatal contributions of the maternal microbiome on offspring programming. Frontiers in Neuroendocrinology, 55. https://doi.org/10.1016/J.YFRNE.2019.100797
Lebwohl, B., Sanders, D. S., & Green, P. H. R. (2018). Coeliac disease. The Lancet, 391(10115), 70–81. https://doi.org/10.1016/S0140-6736(17)31796-8
Leonard, M. M., Karathia, H., Pujolassos, M., Troisi, J., Valitutti, F., Subramanian, P., Camhi, S., Kenyon, V., Colucci, A., Serena, G., Cucchiara, S., Montuori, M., Malamisura, B., Francavilla, R., Elli, L., Fanelli, B., Colwell, R., Hasan, N., Zomorrodi, A. R., … Team, C. S. (2020). Multi-omics analysis reveals the influence of genetic and environmental risk factors on developing gut microbiota in infants at risk of celiac disease. Microbiome, 8. https://doi.org/10.21203/RS.2.24237/V1
Leonard, M. M., Sapone, A., Catassi, C., & Fasano, A. (2017). Celiac disease and nonceliac gluten sensitivity: A review. JAMA - Journal of the American Medical Association, 318(7), 647–656. https://doi.org/10.1001/JAMA.2017.9730
Lev, L., Petersen, K., Roberts, J. L., Kupferer, K., & Werder, S. (2024). Exploring the Impact of Folic Acid Supplementation and Vitamin B12 Deficiency on Maternal and Fetal Outcomes in Pregnant Women with Celiac Disease. Nutrients , 16(18). https://doi.org/10.3390/NU16183194
Lionetti, E., & Catassi, C. (2015). The Role of Environmental Factors in the Development of Celiac Disease: What Is New? Diseases, 3(4), 282. https://doi.org/10.3390/DISEASES3040282
Ludvigsson, J. F., Leffler, D. A., Bai, J. C., Biagi, F., Fasano, A., Green, P. H. R., Hadjivassiliou, M., Kaukinen, K., Kelly, C. P., Leonard, J. N., Lundin, K. E. A., Murray, J. A., Sanders, D. S., Walker, M. M., Zingone, F., & Ciacci, C. (2013). The Oslo definitions for coeliac disease and related terms. Gut, 62(1), 43–52. https://doi.org/10.1136/GUTJNL-2011-301346
Ludvigsson, J. F., & Murray, J. A. (2019). Epidemiology of Celiac Disease. Gastroenterology Clinics of North America, 48(1), 1–18. https://doi.org/10.1016/J.GTC.2018.09.004
Martins, C. L. D. S., Gandolfi, L., Tauil, P. L., Picanço, M. D. A. R., De Araujo, M. O. G., & Pratesi, R. (2006). Doença celíaca e infertilidade feminina: Associaç ão freqüentemente negligenciada. Revista Brasileira de Ginecologia e Obstetricia, 28(10), 601–606. https://doi.org/10.1590/S0100-72032006001000006
McAllister, B. P., Williams, E., & Clarke, K. (2019). A Comprehensive Review of Celiac Disease/Gluten-Sensitive Enteropathies. Clinical Reviews in Allergy and Immunology, 57(2), 226–243. https://doi.org/10.1007/S12016-018-8691-2
Mesa, M. D., Loureiro, B., Iglesia, I., Gonzalez, S. F., Olivé, E. L., Algar, O. G., Solana, M. J., Perez, M. J. C., Sainz, T., Martinez, L., Escuder-Vieco, D., Parra-Llorca, A., Sánchez-Campillo, M., Martinez, G. R., Roig, D. G., Gruz, M. P., Andreu-Fernández, V., Clotet, J., Sailer, S., … Cabañas, F. (2020). The evolving microbiome from pregnancy to early infancy: A comprehensive review. Nutrients, 12(1). https://doi.org/10.3390/NU12010133
Murray, J. A., Frey, M. R., & Oliva-Hemker, M. (2018). Celiac Disease. Gastroenterology, 154(8), 2005–2008. https://doi.org/10.1053/J.GASTRO.2017.12.026
Olivares, M., Benítez-Páez, A., de Palma, G., Capilla, A., Nova, E., Castillejo, G., Varea, V., Marcos, A., Garrote, J. A., Polanco, I., Donat, E., Ribes-Koninckx, C., Calvo, C., Ortigosa, L., Palau, F., & Sanz, Y. (2018). Increased prevalence of pathogenic bacteria in the gut microbiota of infants at risk of developing celiac disease: The PROFICEL study. Gut Microbes, 9(6), 551–558. https://doi.org/10.1080/19490976.2018.1451276
Oliveira, D. C. L. de, Silva, V. M. B. da, & Silva, L. M. C. da. (2022). Desafios da adesão à dieta sem glúten. Research, Society and Development, 11(2), e34411226008. https://doi.org/10.33448/RSD-V11I2.26008
Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paul. Enferm., 20(2). https://doi.org/10.1590/S0103-21002007000200001
Risnes, L. F., Reims, H. M., Doyle, R. M., Qiao, S. W., Sollid, L. M., Lundin, K. E. A., & Christophersen, A. (2024). Gluten-free diet induces rapid changes in phenotype and survival properties of gluten-specific T cells in celiac disease. Gastroenterology, 167(2), 250–263. https://doi.org/10.1053/J.GASTRO.2024.03.027
Rubio-Tapia, A., Hill, I. D., Kelly, C. P., Calderwood, A. H., & Murray, J. A. (2013). ACG clinical guidelines: Diagnosis and management of celiac disease. American Journal of Gastroenterology, 108(5), 656–676. https://doi.org/10.1038/AJG.2013.79
Saccone, G., Berghella, V., Sarno, L., Maruotti, G. M., Cetin, I., Greco, L., Khashan, A. S., McCarthy, F., Martinelli, D., Fortunato, F., & Martinelli, P. (2016a). Celiac disease and obstetric complications: a systematic review and metaanalysis. American Journal of Obstetrics and Gynecology, 214 2(2), 225–234. https://doi.org/10.1016/J.AJOG.2015.09.080
Saccone, G., Berghella, V., Sarno, L., Maruotti, G. M., Cetin, I., Greco, L., Khashan, A. S., McCarthy, F., Martinelli, D., Fortunato, F., & Martinelli, P. (2016b). Celiac disease and obstetric complications: A systematic review and metaanalysis. American Journal of Obstetrics and Gynecology, 214(2), 225–234. https://doi.org/10.1016/J.AJOG.2015.09.080
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of business research, 104, 333-339. https://doi.org/10.1016/j.jbusres.2019.07.039
Serin, Y., Manini, C., Amato, P., & Verma, A. K. (2024). The Impact of a Gluten-Free Diet on Pregnant Women with Celiac Disease: Do We Need a Guideline to Manage Their Health? Gastrointestinal Disorders, 6(3), 675–691. https://doi.org/10.3390/GIDISORD6030045
Tersigni, C., Castellani, R., De waure, C., Fattorossi, A., De Spirito, M., Gasbarrini, A., Scambia, G., & Di Simone, N. (2014). Celiac disease and reproductive disorders: Meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Human Reproduction Update, 20(4), 582–593. https://doi.org/10.1093/HUMUPD/DMU007
Tursi, A., Giorgetti, G., Brandimarte, G., & Elisei, W. (2008). Effect of gluten-free diet on pregnancy outcome in celiac disease patients with recurrent miscarriages. Digestive Diseases and Sciences, 53(11), 2925–2928. https://doi.org/10.1007/S10620-008-0242-X
Utiyama, S. R. D. R., Reason, I. J. T. D. M., & Kotze, L. M. D. S. (2004). Genetics and immunopathogenics aspects of the celiac disease: A recent vision. Arquivos de Gastroenterologia, 41(2), 121–128. https://doi.org/10.1590/S0004-28032004000200010
Wagner, B. A., Zork, N., Blackett, J. W., Green, P. H. R., & Lebwohl, B. (2020). Characteristics and Maternal–Fetal Outcomes of Pregnant Women Without Celiac Disease Who Avoid Gluten. Digestive Diseases and Sciences, 65(10), 2970–2978. https://doi.org/10.1007/S10620-020-06232-3
Yeo, E., Brubaker, P. L., & Sloboda, D. M. (2022). The intestine and the microbiota in maternal glucose homeostasis during pregnancy. Journal of Endocrinology, 253(1), R1–R19. https://doi.org/10.1530/JOE-21-0354
Ziętek, M., Celewicz, Z., & Szczuko, M. (2021). Short‐chain fatty acids, maternal microbiota and metabolism in pregnancy. Nutrients, 13(4). https://doi.org/10.3390/NU13041244
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Júlia Costa Dias; Renata Ribeiro Lustosa Vieira; Simone Gonçalves de Almeida
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
