Wednesday, May 19, 2010

Do cesareans increase the risk of celiac disease?

In a Reuters' report this week on new cesarean research, the headline at least asks the question, 'Do c-sections increase the risk of celiac disease?', but unfortunately, many more media reports and blogs are stating that there IS a significant association between the two, and no doubt it'll soon start to appear on lists of 'reasons why women shouldn't choose a cesarean.'

Probably not
This is what I took away from the report. Firstly, as always, it's a good idea to take a look at the research yourself (click here), and if celiac disease is a particular risk that concerns you (e.g. perhaps it already affects a family member), you might want to get hold of a copy of the full text of the research.

Secondly, from what I can ascertain, the research involved children who had been delivered by ALL types of cesarean delivery - including both planned and emergency surgery - so as always, it's very difficult to make a judgment about how much women having planned cesareans need to worry.

Thirdly, the report states that Dr. Daniel Leffler, director of clinical research at the Celiac Disease Center at Boston's Beth Israel Deaconess Medical Center, said that "many of the children's mothers may have had undiagnosed celiac disease. Given that celiac disease can be inherited, and that undiagnosed celiac disease increases the risk of cesarean section, undiagnosed disease 'would be more than enough to explain the increased number of cesareans'. Enough said.

Identify celiac disease in women
It's worth reading the report yourself of course, but personally, I'm not convinced that this reported increased risk (28% versus 19%) is specifically related to planned cesareans on maternal request in otherwise healthy pregnancies, and I think the most important message we should take from Dr. Leffler's research is this:

The results "may mean we need to be looking for celiac disease in young women who want to become pregnant... He noted that when celiac disease is treated with a gluten-free diet, the risk for cesarean section is no higher than for the average woman. Untreated celiac disease, Leffler added, can have effects on the fetus as well, including slowing its growth and a higher risk of premature birth."

No comments: