Limited risks of major congenital anomalies in children of mothers with coeliac disease: a population-based cohort study.

Abstract

To examine major congenital anomaly (CA) risks in children of mothers with coeliac disease (CD) compared with mothers without CD. Population-based cohort study. Linked maternal-child medical records from a large primary care database from the UK. A total of 562,332 live singletons of mothers with and without CD in 1990-2013. We calculated the absolute major CA risks in children whose mothers had CD, and whether this was diagnosed or undiagnosed before childbirth. Logistic regression with a generalised estimating equation was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) for CAs associated with CD. Fourteen system-specific major CA groups classified according to the European Surveillance of Congenital Anomalies and neural tube defects (NTDs). Major CA risk in 1880 children of mothers with CD was 293 per 10,000 liveborn singletons, similar to the risk in those without CD (282; aOR 0.98, 95% CI 0.74-1.30). The risk was slightly higher in 971 children, whose mothers were undiagnosed (350; aOR 1.14, 95% CI 0.79-1.64), than in 909 children whose mothers were diagnosed (231; aOR 0.80, 95% CI 0.52-1.24). There was a three-fold increase in nervous system anomalies in the children of mothers with undiagnosed CD (aOR 2.98, 95% CI 1.06-8.33, based on five exposed cases and one had an NTD), and these women were all diagnosed with CD at least 4 years after their children were born. There was no statistically significant increase in risk of major CAs in children of mothers with coeliac disease overall, compared with the general population.