Vitamin D, omega-3 and iron consumption during pregnancy not related to coeliac disease in infants
Vitamin D, omega-3 fatty acid (n-3 FAs), and iron consumption during pregnancy is not associated with coeliac disease (CD) or coeliac disease autoimmunity (CDA), according to the TEDDY* study presented at the 49th meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2016 in Athens, Greece.
Vitamin D and n-3 FAs intake during pregnancy did not predict CDA development in infants, even after adjusting for country, sex, duration of breastfeeding, and first degree relative with CD (hazard ratio [HR], 1.03, 95 percent confidence interval [CI], 0.95-1.13; p=0.45; and HR, 0.93, 95 percent CI, 0.83-1.04; p=0.20, respectively). CD risk was also not associated with vitamin D or n-3 FAs intake (HR, 1.06, 95 percent CI, 0.92-1.22; p=0.43; and HR, 0.95, 95 percent CI, 0.77-1.16; p=0.61, respectively). Iron supplements had no association with CDA or CD (HR, 0.93, 95 percent CI, 0.81-1.07; p=0.30; and HR, 1.01, 95 percent CI, 0.80-1.26; p=0.96, respectively). [ESPGHAN 2016, abstract G-O-042]
This prospective observational study recruited 6,627 children carrying human leukocyte antigen (HLA) genotype and increased risk for type 1 diabetes and CD, from Finland, Sweden and the US. The children were followed until they developed type 1 diabetes or until 15 years of age. The testing for CDA started from the 2 year visit and continued annually.
Two outcomes were measured: CDA defined as positive test for transglutaminase autoantibodies (tTGA) on two consecutive visits at least 3 months apart; and CD defined as a biopsy sample showing a Marsh score ≥2 or tTGA levels >100 U/mL.
Duration, frequency/dose of vitamin D, n-3 FAs, and iron supplementation was recalled by the mother 3-4 months postpartum. Overall 66, 17 and 94 percent of mothers took vitamin D, n-3 FAs, and iron supplements, respectively. Cox proportional hazard model was used to calculate the amount of nutrients from the supplements and the risk or CD or CDA.
CDA and CD were confirmed in 17 percent (n=1,136) and 36 percent (n=409) of the infants, respectively.
Several environmental factors, other than gluten exposure, are thought to cause CD in individuals with a genetic predisposition, said the researchers, pointing to the scarcity of literature on maternal exposures during pregnancy and CD risk. This study was conducted to observe the effect of supplements consumed during pregnancy and CD risk in the offspring.