It is important that people with coeliac disease are followed up regularly, particularly at times of stress, for example, pregnancy.
There is an increased risk of reproductive problems in women with untreated coeliac disease. If a gluten-free diet is not followed, it can lead to a low birth weight baby, an increased risk of having a preterm baby and an increased likelihood of requiring a caesarean section.
Depending on individual assessment and diet, supplementation with calcium, iron, and vitamin B12 may be required. It’s best to get vitamins and minerals from the food you eat, but when you are pregnant you may need to take some supplements as well.
If you have any concerns, it may be helpful to see a dietitian, who can assess your diet and ensure you are getting enough nutrients for you and your baby.
The Department of Health recommends that all women take a folic acid supplement of 400 micrograms a day for three months before conception and for the first three months of pregnancy to protect against neural tube defects such as spina bifida. There is no evidence to suggest that people with coeliac disease are more at risk of these defects and recommendations for folic acid are the same for people with coeliac disease as the rest of the population.
If your folic acid levels are low before conception, you may need to take a higher dose of folic acid. This should be discussed with your GP as they can assess your individual needs.
It’s possible that folic acid supplementation may mask the symptoms of vitamin B12 deficiency, which is more common in people with coeliac disease. It’s important that you stay in regular contact with your healthcare team during your pregnancy so they can monitor you.