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Gynecologic and Obstetric Findings Related to Nutritional Status and Adherence to a Gluten-Free Diet in Brazilian Patients with Celiac Disease

Kotze, L M S PHD

Journal of Clinical Gastroenterology: August 2004 - Volume 38 - Issue 7 - p 567-574
doi: 10.1097/01.mcg.0000131720.90598.6a
Alimentary Tract: Clinical Research
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This study shows a broad analysis of gynaecological and obstetrical disturbances in patients with celiac disease in relation to their nutritional status and adherence to a gluten-free diet. Seventy-six adult celiac patients were analyzed according to nutritional status and 18 children/adolescents to gluten-free diet adherence. As controls, 84 adults and 22 adolescents with irritable bowel syndrome were used The significant findings were observed as follow: adult celiac patients, irrespective of the nutritional status, were younger than controls, presented delayed menarche, secondary amenorrhea, a higher percentage of spontaneous abortions, anemia and hypoalbuminemia. No differences were observed regarding the number of pregnancies, age at menopause and duration of the reproductive period. After treatment, patients presented with normal pregnancies and one patient presented spontaneous abortion. The adolescents who were not adherent to gluten-free diet presented delayed menarche and secondary amenorrhea. In conclusion, gluten per se could explain the disturbances and malnutrition would worsen the disease in a consequent vicious cycle. Therefore, celiac disease should be included in the screening of reproductive disorders.

From Gastroenterology Service, Cajuru Hospital, Pontifical Catholic University of Paraná; Laboratory of Immunopathology, Clinical Hospital, Federal University of Paraná; Curitiba, Paraná, Brazil

Received for publication June 17, 2004;

accepted January 7, 2004

Reprints: Professor L. M. S. Kotze, Rua Bruno Filgueira, 369 Conjunto 1205, Curitiba Paraná Brazil, CEP 80.240-220 (e-mail: loretekotze@hotmail.com).

© 2004 Lippincott Williams & Wilkins, Inc.