Why Every Woman Needs To Have a Gluten Antibody Test BEFORE Pregnancy

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Why Every Woman Needs To Have a Gluten Antibody Test BEFORE Pregnancy

It is becoming more well known that poor digestion, leaky gut and dysbiosis can lead to health problems outside of the GI tract. In several previous articles I have discussed the effects of gluten on the brain as well as the effects of gluten on the cardiovascular system. In addition to these hazards, current research indicates a clear relationship between a mother's sensitivity to gluten and the mental health of her child.

In this study published in The American Journal of Psychiatry in June 2012, Swedish researchers investigated whether levels of Immunoglobulin G (IgG) -- in particular those immunoglobulins directed at gluten -- were associated with a later diagnosis of a non-affected psychotic disorder (like schizophrenia).

Immunoglobulin G

IgG immunogloblulins are the immune factors passed on to the newborn from the mother, predominately in the last month of pregnancy. They are derived from maternal circulation and transferred across the placenta. These factors respond to the immediate environment that the baby will be born into and will protect the baby from possible antigens such as the fur and hair of dogs and cats, as well as other potential environmental allergens.

Since they come directly from the mother's circulation, high levels of particular IgG globulins are indicative of the mother's reactivity to these substances. In this case, the IgG globulins studied were to gliadin -- a component of gluten that can be measured in the blood.

The Swedish Medical Birth Register

In Sweden, records and blood samples from pregnant mothers have been kept since 1973 via The Swedish Medical Birth Register. This register includes information for all deliveries in Sweden as well as data from the prenatal and neonatal periods.

Blood is collected from all newborns as part of a screening program and kept at Karolinska University Hospital. When a person consents to it, researchers can locate the blood spot and use it for study, as they did here.

The investigators choose a population of babies born between 1975 and 1985 with verified register-based diagnoses of non-affective psychoses made as in-patients between 1987 and 2003 and as out-patients between 1997 and 2003. They compared these to subjects without non-affective psychoses, of similar sex, dates of birth, birth hospital and municipality, among other details, for a total of 211 case studies and 553 comparison studies.

The researchers analyzed the levels of IgG antibodies to gliadin (an active component of gluten) and also casein (milk protein). In this study there was no relationship found between the casein antibodies and psychoses.

The Results May Astound You

The scientists found that mothers in the group with the top 10% of anti-gliadin antibodies had offspring with over a 70% likelihood to develop schizophrenia later in life. Mothers in the group with the top 5% of anti-gliadin antibodies had offspring with a whopping 240% chance of developing schizophrenia as an adult.

It goes without saying that there is a relationship here that needs further investigation and more widespread understanding in order for it to become protocol to test women of child bearing age for these antibodies before they become pregnant.

It has been shown is this study published  in Human Reproduction in 2010  that untreated celiac disease in the mother increases the risk for adverse pregnancy outcomes such as low birth weight, intrauterine growth restriction, and prematurity.

Celiac disease and risk of adverse fetal outcome: a population-based cohort study, published in Gastroenterology in 2005 also showed that undiagnosed maternal celiac disease is a risk factor for unfavorable fetal outcomes, but the risks are reduced when celiac disease has been diagnosed and can be treated with a gluten-free diet. The unfavorable outcomes referred to, intrauterine growth retardation, low birth weight (<2500 g), very low birth weight (<1500 g), preterm birth (<37 gestational weeks), very preterm birth (<30 gestational weeks), and Caesarean section. The mothers who received the diagnosis of celiac disease before birth was not associated with these adverse fetal outcomes.

Clearly, once the diagnosis of celiac disease is made, the quick and simple action of a gluten-free diet may be taken to improve the health of the mother and the developing baby.

As published in the American Journal of Gastroenterology in 1999, Khashan et al found that the offspring of mothers with celiac disease had lower birth weight than expected and more than a three-fold higher risk of intrauterine growth retardation when birth occurred before the first hospitalization for the disease. They conclude that treatment of celiac women is important in the prevention of fetal growth retardation.

Effect of gluten-free diet on pregnancy outcome in celiac disease patients with recurrent miscarriages, published in the Digestive Diseases and Science in 2008 found that a gluten-free diet favored a positive outcome for women with celiac disease and recurrent miscarriage. Recurrent miscarriage is a common condition in young and otherwise healthy women. Simply testing women with this problem for celiac disease or gluten sensitivity could potentially resolve the problem and prevent unnecessary infertility treatments and heartache.

There are more studies that show similar findings and it becomes clear that celiac disease in the mother is a critical marker and predictor of the mental health of the child due to the many development problems that can occur during the pregnancy.

Risk Associated with Low Birth Weight

In this study published in the Archives of General Psychiatry in 2010, researchers found that there is an association between birth weight and adult mental disorder, but there is no indication this effect is specific to birth weight less than 2500 g or to schizophrenia. They conclude that further research should explore common disorder-specific mechanisms that may link birth weight to development of psychiatric disorder in adulthood.

This study published in the Archives of General Psychiatry in 1999 set out to study specific risk factors, as well as sets of risk factors for low birth weight, representing 3 different etiologic mechanisms: (1) malnutrition during fetal life; (2) extreme prematurity; and (3) hypoxia or ischemia (when the body is deprived of adequate oxygen supply).

The investigators found an association between obstetric complications and schizophrenia. Although pre-eclampsia was the strongest individual risk factor, there was evidence of increased risk associated with all 3 etiologic mechanisms.

Relationship between Celiac and Schizophrenia

In 2011 this study published in Schizophrenia Bulletin set out to examine the relationship between schizophrenia and celiac disease. The researchers found that people with schizophrenia have higher than expected titers of antibodies related to celiac disease and gluten sensitivity. (my emphasis)

Markers of gluten sensitivity and celiac disease in bipolar disorder, published in Bipolar Disorder in 2011 found that individuals with bipolar disorder have increased levels of IgG antibodies to gliadin. Increased levels of IgG antibodies is not a formal diagnosis of celiac disease, but it clearly indicates a sensitivity to a protein in gluten.

Even back in 1976 connections were made between wheat gluten and mental disorders. This study published in Science, found wheat gluten to have "a primary schizophrenia-promoting effect."

It is clear that celiac disease and/or elevated antibodies to gliadin/gluten puts a baby at an increased risk for quite a few problems, including low birth weight, prematurity, small babies, as well as further risk for mental disorders like schizophrenia and bipolar disorder.

Non-Celiac Gluten Sensitivity is an Issue

While many of these studies target celiac disease, there are even more mothers with undiagnosed non-celiac gluten sensitivity. This is now in the scientific literature as a true condition -- as discussed by Dr. Fasano --  and needs to be addressed as well. These mothers may have elevated anti-gliadin antibodies and not know it because the test was never performed -- which is so often the case. The babies of these mothers are at risk.

Prevention is Key

None of this happens when the mother is informed of her IgG status to gliadin/gluten or she keeps a diagnosis of celiac disease and she takes steps to stay on a gluten-free diet. It make sense to perform a simple blood test, along with the other blood tests that are standards of care for women considering pregnancy.

With the backing of scientific literature, it's just common sense to implement these simple tests into the prenatal protocols.

If health officials and doctors would read the scientific literature more often we would have a system based on real preventative health-care rather than the sick-care model we have today.

What do you think? Leave a comment and let me know!

[Note: for related research read Dr. Kelly's Brogan's recent article, "Is Wheat Making You Wait for Babies? The Gluten Infertility Link."

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