Gluten can affect many aspects of pregnancy. From fetal development to the risk of miscarriages and infertility. This is the first post in a 3-part series. For additional readings on gluten’s effect on pregnancy please see my other articles:
The way celiac disease develops is still poorly understood. Could the consumption of gluten while in-utero play a role in the development of celiac disease?
Celiac disease is a medical condition in which the absorptive surface of the small intestine is damaged by gluten. Gluten is the primary protein found in wheat products. This results in an inability of the body to absorb nutrients: protein, fat, carbohydrates, vitamins and minerals, which are necessary for good health. (1) In Canada, 360,000 people or about 1% of Canadians have celiac disease. (2)
First-degree relatives (parents, siblings, children) of a person with celiac disease have about a 10% chance of having this condition. Therefore, family members, especially if they have symptoms, should be tested for celiac disease. (3)
The way celiac disease develops is still poorly understood. At the time of this writing, we know there are genetic factors that influence celiac disease though we’re not sure what else contributes to its development.
People with celiac disease carry one or both of the genes named HLA DQ2 and HLA DQ8. Surprisingly, so do up to 25-30% of all people. Carrying HLA DQ2 and/or DQ8 is not a diagnosis of celiac disease nor does it mean you will develop celiac disease. (4) Therefore, celiac disease is not strictly a genetic condition – there are other factors contributing to its development.
Why do certain people get celiac disease and not everyone?
At the time of the writing, we know that the development of celiac disease involves some combination of genetics and the environment. But the whole picture is still unclear. Here’s a brief rundown of what we know to be true about developing celiac disease:
- You have to ingest gluten
- Gluten is what triggers the autoimmune reaction.
- Celiac disease is the only autoimmune disease where the exact environmental trigger has been isolated.
- You need to have the required genes
- I touched on this above regarding the HLA DQ genes.
- It is thought there are other, yet to be identified, genes that are more likely to cause celiac disease.
We know that celiac disease is a genetic, autoimmune condition that requires exposure to gluten to be expressed. First degree relatives of one with celiac disease are at increased risk. This confirms that celiac disease has a strong genetic component.
While we do know these aspects, there are many more questions that need to be answered through future research.
Is celiac disease passed from mom to baby?
Our immune system begins developing while in-utero. As such, it is thought that if mom is allergic to gluten, she may pass on the antibodies to gluten to her baby. Could this be what causes celiac disease?
In one study, researchers looked to identify whether gluten consumption or avoidance impacted the risk of having a child diagnosed with celiac disease. A collection of over six thousand mothers from four different countries (USA, Germany, Sweden, and Finland) were examined in their last trimester of pregnancy. (4)
The results of this study showed that there was no correlation between consumption of gluten during pregnancy and celiac disease. (5)
Of the six thousand babies studied after birth, five percent went on to develop celiac disease. Five percent is the current prevalence of celiac disease worldwide. The percentages for each country were consistent with the nation’s national averages as well. (6)
This study brought forth the conclusion that the development of celiac disease is much more complicated than originally thought. There are multiple factors that result in its development. It is not as simple as consuming (or avoiding) gluten during pregnancy. Instead, genetics and other environmental factors that we are currently unaware of likely contribute to the development of celiac disease. (7)
In a follow-up to the above study, researchers investigated whether the age in which gluten is introduced to children played a role in the development of celiac disease.
Does the age at which we start consuming gluten alter our risk for developing celiac disease?
In a follow-up study, gluten was introduced before seventeen weeks postpartum and after thirty weeks. (8) Could timing increase or decrease the risk?
The study found that the timing before seventeen weeks or after twenty-six weeks has no influence on a child developing celiac disease. (9)
These studies confirm that celiac disease is not something that develops in response to the food we eat (or avoid). More research is needed to determine the precise causative factors for celiac disease.
Until there is more information on the way(s) in which celiac disease develops, take confidence in the research. Consuming gluten either during pregnancy or shortly afterward will not result in your child developing celiac disease.
While gluten consumption may not trigger celiac disease, research has shown that it can contribute to a multitude of other illnesses. Please see the other posts in this series for more information.
Does breastfeeding decrease the risk of developing celiac disease?
It was originally thought that breastfeeding decreased the risk of developing celiac disease. Additionally, it was thought that if celiac disease was going to develop, breastfeeding would delay it.
This wasn’t just an opinion either. There were medical journals that showed how breastfeeding decreased the risk of celiac disease. (10, 11) Unfortunately, this was proven to be false. A study published in 2016 covered celiac disease in 8 countries.
Their findings: breastfeeding duration was not shown to alter the risk for celiac disease. (12)
Why does celiac disease often develop after pregnancy?
Celiac disease (and most other autoimmune conditions) seem to develop after pregnancy. Could childbirth be a potential trigger?
Recent research suggests that it is not the act of child birth, but instead a stressful life event that triggers the autoimmune reaction. (13) For many women, childbirth falls into this category. This is especially true when there are complications during pregnancy. Conditions like high blood pressure, severe anemia, placental abruption, or threatened miscarriage all increase the risk of developing celiac disease. (14)
This is not to say that pregnancy or stressful life events cause celiac disease (or any other autoimmune condition). Instead, these events serve as the catalyst. The conditions to develop celiac disease are put in place through genetic and environmental factors. Childbirth, or any other stressful event, merely serve as the trigger.
Put another way, our environment and genetics load the gun to develop celiac disease. A stressful life event is what pulls the trigger.
So, by the end of this post, you should be aware of the following:
- Celiac disease has a strong genetic component.
- More research is needed to find the exact gene or trigger that causes it.
- There is no correlation between your child developing celiac disease and whether you consume or avoid gluten during pregnancy.
- The age at which a child is introduced to gluten does not alter his/her risk for developing celiac disease.
- Breastfeeding does not decrease the risk of developing celiac disease.
- A stressful life event (such as childbirth) can trigger celiac disease. Though it does not cause it.
If you or your partner has celiac disease, your children have a much higher risk of developing celiac disease. In these situations, I would recommend genetic testing and a celiac screen for your children. Additionally, following a 30-day reset diet can help confirm whether a wheat allergy/sensitivity exists.
Now, I want to hear from you.
What did the avoidance (or inclusion) of gluten alter in your pregnancy?
Also published on Medium.