Obstetrical outcomes in pregnant patients following a gluten-free diet: A prospective cohort study

Concerns have been raised about the nutritional adequacy of a gluten-free (GF) diet during pregnancy, specifically in the absence of celiac disease, and its impact on fetal development. The objective of this study was to investigate the association between a GF diet during pregnancy and obstetrical outcomes, with further sensitivity analyses exploring those without celiac disease.

Using data from the ongoing P3 Cohort study, self-reported data were obtained on participant demographics, GF diet, celiac disease, and obstetrical outcomes. Fisher exact, χ², Mann-Whitney U and two-sample t-tests, and regression models were used to examine differences in patient characteristics and outcomes between those who did and did not follow a GF diet in pregnancy. A sensitivity analysis was conducted to examine outcomes among those without celiac disease.

Of the 2359 participants included, 108 (4.6%) reported following a GF diet in pregnancy. The majority of these individuals (n = 68, 63.0%) were non-celiac. Participants in the GF group were older, more likely to identify as white, and more likely to take prenatal vitamin B supplements. There were no significant differences in obstetrical outcomes between the GF and non-GF participants. Sensitivity analyses excluding patients with celiac disease demonstrated similar results, with no difference in obstetrical outcomes observed.

Following a GF diet in pregnancy, even in individuals without celiac disease, was not associated with adverse obstetrical outcomes. These results provide some reassurance on the safety of a GF diet in pregnancy but require validation in larger studies.