ÇÖLYAK HASTALIĞININ GEBELİK SONUÇLARI ÜZERİNDEKİ ETKİSİ

Amaç Genetik olarak yatkın kişilerde glutene bağlı otoimmun enteropati olarak tanımlanan Çölyak Hastalığının (ÇH) olumsuz gebelik ve yenidoğan sonuçları ile ilişkisini araştırmak ve glütensiz beslenmenin bu sonuçlar üzerindeki etkisini incelemektir. Gereç ve Yöntem Retrospektif olarak tasarlanan bu çalışma, 2017-2022 yılları arasında hastanemizde doğum yapan ÇH olan gebeler ile aynı dönemde doğum yapan sağlıklı gebeler arasında gerçekleştirildi. Hastaların demografik verileri, gebelik komplikasyonları, doğum haftası, doğum kilosu ve yenidoğan yoğun bakım ihtiyacı analiz edildi. Bulgular Çalışma süresince 30 ÇH olan gebe tespit edildi. Kontrol grubu 90 sağlıklı gebeden oluşturuldu. ÇH olan gebelerde maternal yaş daha yüksekti (p= 0,020). Gravide, parite, abortus ve fertilite tedavisi açısından gruplar arsında farklılık saptanmadı. ÇH grubunda çoğul gebelik ve plasenta previa olguları fazla görüldü (p=0,034 ve p=0,003). Erken doğum ÇH grubunda anlamlı derecede fazla bulundu (p=0,000). Diğer gebelik komplikasyonları açısından fark saptanmadı. Glutensiz beslenme, ÇH varlığında gebelik ve yenidoğan sonuçlarını iyileştirmekle birlikte erken doğum kontrol grubundan hala fazla tespit edildi (p=0,006). Sonuç ÇH, gebelikte erken doğum ve olumsuz yenidoğan sonuçları ile ilişkilidir. Glutensiz beslenme olumsuz sonuçlarda azalma yapmakla birlikte ÇH’nın varlığı erken doğum açısından risk teşkil etmektedir.

Anahtar Kelimeler:

Çölyak hastalığı, gebelik, olumsuz sonuç

THE EFFECT OF CELIAC DISEASE ON PREGNANCY OUTCOME

Objective To investigate the association between celiac disease (CD), defined as gluten-induced autoimmune enteropathy in genetically susceptible individuals, and adverse pregnancy and neonatal outcomes and to investigate the effects of a gluten-free diet on these outcomes. Material and Method This retrospective study was conducted between pregnant women with CD, who delivered in our hospital between 2017-2022, and healthy pregnant women who delivered during the same period. Patient demographic characteristics, pregnancy complications, gestational age at delivery, birth weight, and neonatal intensive care needs were analyzed. Results During the study period, 30 pregnant women with CD were identified. The control group was formed by 90 healthy pregnant women. Maternal age was higher in pregnant women with CD (p=0.020). There was no difference between groups in gravidity, parity, abortion, and fertility treatment. Multiple pregnancies and placenta previa occurred more frequently in the CD group (p=0.034 and p=0.003, respectively). Preterm births were significantly more common in the CD group (p=0.000). There were no differences between groups in other pregnancy complications. The gluten-free diet improved pregnancy and neonatal outcomes in the CD group. However, the increase in preterm birth rate remained compared to the control group (p=0.006). Conclusion CD is associated with preterm birth in pregnancy and adverse neonatal outcomes. Although a gluten-free diet reduces adverse outcomes, the presence of CD continues to pose a risk for preterm birth.

Keywords:

Adverse outcome, celiac disease, pregnancy,

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