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Pregnancy Antitissue Transglutaminase Immunoglobulin A Seropositivity and Maternal and Infant Health in the Child Health and Development Studies

Year: 2025

Type: article

Abstract: INTRODUCTION: We examined associations between pregnancy antitissue transglutaminase immunoglobulin A (tTG-IgA) seropositivity, a screening test for celiac disease, and celiac-related conditions in pregnancy and offspring health outcomes. We hypothesized that seropositivity would identify pregnant women and infants at risk of poor health. METHODS: The Child Health and Development Studies enrolled pregnant women from 1959 to 1967 and prospectively followed their pregnancies and offspring. tTG-IgA was measured from stored pregnancy serum using QUANTA Lite R h-tTG IgA ELISA. Pregnant women were randomly selected into a "high-risk" (n = 937) or background-risk (n = 831) group based on high-risk markers of celiac comorbidity. We used logistic regression to compare associations between tTG-IgA seropositivity and high-risk markers in pregnancy, placental to birth weight ratio (PWR), and infant weight gain through 1 year. RESULTS: The overall prevalence of tTG-IgA seropositivity was 3%. Seropositivity was associated with having 2 or more maternal high-risk markers (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.2-5.3, including diabetes, nutritional deficiency, gastrointestinal complications, Down syndrome child, cesarean delivery, and thyroiditis), lower PWR (OR 2.9, 95% CI 1.3-6.0), and lower weight gain in late infancy (OR 2.3, 95% CI 1.0-5.4). Offspring associations did not differ by maternal risk group, suggesting that seropositivity rather than comorbidity was the underlying risk factor. DISCUSSION: tTG-IgA seropositivity was associated with the presence of 2 or more markers of celiac comorbidity. Offspring exposed to maternal seropositivity had poorer fetal growth and lower infant weight gain. Findings support the potential beneficial role of tTG-IgA screening during pregnancy, both for the pregnant woman and exposed offspring.

Source: The American Journal of Gastroenterology

DOI: 10.14309/ajg.0000000000003424