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Congenital malformation risk low in children of parents with celiac disease
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Children of parents with celiac disease had an increased but minor risk for congenital malformation, according to results from a nationwide study in Sweden.
To investigate risk for neural tube defect, congenital heart defect, orofacial cleft and other congenital malformations (CM) in children of parents with celiac disease (CD), Jonas F. Ludvigsson, MD, PhD, department of pediatrics, Örebro University Hospital, Sweden, and colleagues compared mothers, fathers and children with and without a parental diagnosis of CD. Biopsy reports for CD diagnoses from 28 pathology departments were examined from 1969-2008, and birth records from 1973-2009 were obtained.
Jonas F. Ludvigsson
Of 11,382 children of CD-diagnosed mothers, 5.9% had CM vs. 5.1% of 40,922 children of mothers without CD. Likewise, among 6,002 children with CD-diagnosed fathers, 5.9% had CM compared with 5.1% of 19,600 children of fathers without CD. The adjusted prevalence odds ratios (aPOR) indicated a slightly increased risk for CM in offspring of CD-diagnosed mothers (aPOR=1.15; 95% CI, 1.05-1.26) and fathers (aPOR=1.14; 95% CI, 1-1.29).
Absolute excess CM rates corresponded to 0.8 (95% CI, 0.3-1.3) and 0.7 (95% CI, 0-1.5) per 100 children of CD-diagnosed mothers and fathers, respectively. These risks, however, significantly decreased when data was restricted to 2000 or later (aPOR=1.11; 95% CI, 0.79-1.56, mothers; aPOR=1.01; 95% CI, 0.81-1.26, fathers).
“Women with CD are at no major risk of CM,” Ludvigsson told Healio.com/Gastroenterology. “There is no reason to screen for CD in pregnant women in order to prevent CM.”
In a related editorial, Timothy B. Gardner, MD, section of gastroenterology and hepatology, Dartmouth-Hitchcock Medical Center, wrote “the combination of a diminutive absolute risk, inability to accurately measure [gluten exposure], and the presence of unmeasured confounders … prevents this study from providing enough evidence to support the recommendation of a gluten-free diet for the prevention of celiac disease.
“The results of the study … underscore the importance of developing a prospective national or international database to follow patients longitudinally with well-characterized celiac disease.”
Disclosure: The researchers report no relevant financial disclosures.
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