Environmental Factors Associated With Celiac Disease in Children in Southeast Iran: A Case-Control Study

Celiac disease (CD) is a systemic autoimmune disease associated with several environmental factors in susceptible individuals. Given the lack of CD-related publications in the Mediterranean region as well as its prevalence in southeastern Iran, we decided to assess its potential risk factors.

In this case-control study, 200 children (100 CD and 100 non-CD patients) were recruited via convenience sampling. A survey assessing demographic and medical history (especially perinatal and maternal characteristics) was completed. Then, the odds ratios (ORs) were calculated through conditional logistic regression.

The risk of developing CD increased based on maternal BMI < 18.5 and > 30 kg/m² (OR: 4.2, 95% CI: 1.3-13.2, and OR: 1.5, 95% CI: 0.6-3.7, respectively), living in rural areas (OR: 6.2, 95% CI: 2.6-14.2), use of antacids (OR: 7.4, 95% CI: 0.9-61.7), positive family histories of CD (OR: 11.8; 95% CI: 4.0-34.9), consanguine marriages (OR: 1.9, 95% CI: 1.1-3.5), and exclusive breastfeeding for 3 months (OR: 11, 95% CI: 1.3-87.6). Furthermore, premature rupture of membranes (OR: 0.489, 95% CI: 0.2-0.9) was associated with lower risks of CD.

There is a need to increase awareness of the factors associated with CD in both society and among healthcare providers, to not only reduce exposure but diagnose quicker.