The prevalence of celiac disease in mothers and fathers of preterm or low birth weight newborns

Abstract: Celiac disease is a T- cell mediated chronic inflammatory malabsorption disease of small intestine that triggered by dietary exposure gluten present in cereals and develops in genetically susceptible individuals. Although it classically manifests with malabsorption and growth retardation, it may also affect the other systems of the body, which termed as atypical symptoms (short stature, dental defects, recurrent anemia, infertility, preterm and/or low birth weight etc). The prevalence of the disorder is 1/100- 300. We investigated the frequency of celiac disease affects in mothers and fathers who had preterm or low birth weight newborns.Material and Methods: The risk group consisted 164 preterm (gestastionel age <37 weeks) or low birth weight newborns (birth weight <2500 g) and their 159 mothers and 157 fathers and the control group consisted 123 healthy newborns and their 246 parents. Tissue transglutaminase IgA was used for screening and serum IgA for detecting selective IgA deficiency in all of the parents? blood. Endoscopic duodenal biopsy was performed in the seropositive cases. Some parental and perinatal features of the cases listed in the risk group were recorded.Results: Two (1.3%-1/80) mothers and three (1.9%-1/52) fathers in the patient group and one mother (0.8%-1/123) in the control group were found seropositive. In studied cases, the seropositivity ratio was 1/94 (1.1%). Celiac prevalence in mothers, fathers and parents (mothers or fathers) who had preterm newborns was 1/57 (1.8%), 1/57 (1.8%) and 1/29 (3.5%), respectively. One of three serpositive fathers had low birth weight newborn (2%-1/50). Endoscopic duodenal biopsy was performed in four cases in the risk group, and positive histological findings were confirmed according to Marsh-Oberhuber classification in three cases (0.9%-1/105). Biopsy proven celiac disease prevalence was 1/87 (0,5%) in all studied cases. Two seropositive mothers refused endoscopic biopsy. Serum IgA levels were analysed in all cases and low values were not determined regarding age and sex. Presence of celiac disease in the mother, father or parents had no effect on newborns being premature or low birth weight. On the other hand when birth weights of the newborns were analysed, the weights of the babies of seropositive mothers, seropositive fathers and seropositive parents were 214 g (p<0.05), 320 g and 259 g lower than those of seronegative ones respectively. Newborns of two seropositive mothers in the risk group were premature. All the newborns of the seropositive fathers were in the risk group. When the characteristics of the parents and perinatal features were examined, it was determined that infertility and frequent or multiple pregnancies, preeklampsi, premature rupture of membranes in the mother and fetal distress, respiratory disorders, olygohydramios and hypoglisemia in the newborns were more frequent in preterm babies than control newborns (p<0,05). Multiple pregnancies were higher in low birth weight newborns than the other cases (p<0.05) when analyzed by multivariate test.Conclusion: The prevalence of celiac disease in the parents who have preterm or low birth weight is higher than the healthy population (1/63 vs 1/246). Thus, celiac screening in parents of preterm or low birth weight might be recomended.Key words: Celiac disease, preterm birth, mother and father, prevalence