celiac diseaseThe anti-tTG (antibody tissue transglutaminase) is found in celiac disease patients. According to a new study published in the journal Gastroenterology, the level of this antibody could predict fetal and birth weight issues. Elevations in anti-tTG were associated with low fetal weight and low birth weight.

Many clinical studies into the effects of celiac disease on pregnancy are observational, especially as the disease process relates to infant health. This study looks deeper into the effects of celiac disease by pinpointing a specific antibody that could be affecting fetal and birth weight. The research is crucial as a large number of patients with celiac disease are never diagnosed with the condition.

The population cohort examined more than 7,000 women. All women included in the study were pregnant. The women were placed in one of three groups – control (negative anti-tTG), intermediate (anti-tTG levels just below diagnosis level) and positive (patients with anti-tTG levels sufficient to diagnose celiac disease).

Fetal weight of patients in the positive group weighed 16 grams less than fetuses in the control group in the second trimester. By the third trimester, the gap increased to 79 grams between the two groups. Despite the fact that women in the intermediate group would not be diagnosed with celiac disease, the intermediate increase in anti-tTG affected fetal weight. At birth, infants in the intermediate group weighed 59 grams less than control infants. Infants in the positive group recorded weight deficits three times that of the intermediate group at 159 grams less.

Anti-tTG levels clearly affect fetal and birth weight, even in patients with antibody levels lower than those required to diagnose celiac disease. Additional research is needed to determine if patients in the intermediate group require additional obstetric or gastrointestinal care and if diagnosis guidelines should be altered to include patients with an intermediate rise in antibodies.

“Researchers need to explore the natural history and long-term consequences of intermediate anti-tTG levels to determine if these levels are caused by pregnancy or whether it reflects a subclinical state of celiac disease that needs follow-up,” wrote Jessica Kiefte-de-Jong, lead study author.

Source: Jessica C. Kiefte–de Jong, Vincent W.V. Jaddoe, André G. Uitterlinden, Eric A.P. Steegers, Sten P. Willemsen, Albert Hofman, Herbert Hooijkaas, Henriette A. Moll. Levels of Antibodies Against Tissue Transglutaminase During Pregnancy Are Associated With Reduced Fetal Weight and Birth Weight. Gastroenterology. 2013 April. doi:10.1053/j.gastro.2013.01.003.