What Is Intrauterine Growth Retardation?

I ntrauterine growth retardation (IUGR) is a fetal development abnormality characterized by failure to grow normally for gestational period. Specifically, it means the developing baby weighs less than 90% of other babies at the same age.

Intrauterine growth retardation puts the baby at increased risk for complications such as premature birth or that the baby will die inside the womb before birth.¹

Intrauterine growth restriction  may be suspected if the size of the pregnant woman’s uterus is small. The condition is usually confirmed by ultrasound. Further tests may be needed to screen for infection or genetic problems if intrauterine growth retardation is suspected.

Q: Why would a baby not grow normally during pregnancy? A: An unborn baby cannot grow normally  if it does not obtain adequate oxygen and nutrition delivered through the placenta from the mother. Factors that impede adequate delivery of nutrition include:

• Poor placenta placement. Conditions that limit or interfere with space for nutrient and oxygen absorption between the placenta and the uterine wall include 1) low attachment of the placenta near or over the cervix where maternal blood supply is poor, 2) pulling away or bleeding between the placenta and uterine wall, 3) multiple placentas (from multiple babies) sharing the uterine wall may limit blood supply to one or more of the fetuses, and 4) the presence of an hydatid mole,  (non-fertilized egg growing wildly), tumor or fibroids taking up space or growing under or into the placenta. 
• Chromosomal abnormalities in the fetus. Conditions such as trisomy 22  have early onset  of  intrauterine growth retardation  in pregnancy. 
• Poor health of the mother. These factors include 1) anemia which impairs the ability of the mother’s blood to deliver adequate oxygen, 2) preeclampsia which interferes with placenta function, 3) diabetes which impairs proper supply of energy, 4) kidney disease, 5) poor diet, 6) malabsorption, 7) high blood pressure or heart disease, 8) clotting disorders, and 9) toxins and infections during pregnancy that may harm the developing baby such as rubella, cytomegalovirus, toxoplasmosis, and syphilis. 
• Risk factors in the mother. Any of the following may contribute to intrauterine growth retardation:¹

• Alcohol abuse.
• Drug addiction.
• Smoking.

What Is Intrauterine Growth Retardation In Celiac Disease and/or Gluten Sensitivity?

1. http://www.nlm.nih.gov/medlineplus/ency/article/001500.htm [↩] [↩]

What Are Congenital Anomalies?

C ongenital anomalies are malformations present in the infant at birth.

Q: What anomalies are present at birth?

A: Some anomalies are inherited while others are caused by a harmful environmental factor during pregnancy such as diet, toxins, infections, metabolic disorders, and radiation.

Examples include cleft lip impairing the ability to eat and speak, clubfoot impairing the ability to walk, congenital heart disease causing heart failure, spina bifida impairing the ability to walk, control the bladder and bowel, and anencephaly causing death.

For example, anencephaly is a defect in the closure of the neural tube during early fetal development. The neural tube is a narrow channel that folds and closes between the 3rd and 4th weeks of pregnancy to form the brain and spinal cord of the embryo. Anencephaly occurs when the “cephalic” or head end of the neural tube fails to close, resulting in the absence of a major portion of the brain, skull, and scalp.

Infants with this disorder are born without a forebrain (the front part of the brain) and a cerebrum (the thinking and coordinating part of the brain). The remaining brain tissue is often exposed–not covered by bone or skin. A baby born with anencephaly is usually blind, deaf, unconscious, and unable to feel pain. Recent studies have shown that the addition of folic acid (vitamin B9) to the diet of women of childbearing age may significantly reduce the incidence of neural tube defects. Therefore it is recommended that all women of childbearing age consume 0.4 mg of folic acid daily. ((National Institute of Neurological Disorders and Stroke))

What Are Congenital Anomalies In Celiac Disease and/or Gluten Sensitivity?

What Is The Puerperium Complicated by Celiac Disease?

C eliac disease complicating puerperium is an adult manifestation of celiac disease that appears during the 6 weeks after delivery of a baby(ies). It is characterized by severe diarrhea in the newly delivered mother and results in malabsorption.

Ordinarily, celiac disease very rarely manifests during pregnancy or after childbirth possibly due to hormonal and immunological changes.

How Prevalent Is The Puerperium Complicated By Celiac Disease?

What Is Miscarriage?

M iscarriage, or spontaneous abortion, is a reproductive failure characterized by loss of an unborn baby before the 20th week of pregnancy.

What Is Miscarriage In Celiac Disease and/or Gluten Sensitivity?

What Is Severe Iron Deficiency Anemia In Pregnancy?

S evere iron deficiency anemia in pregnancy is characterized by abnormal formation of small, pale red blood cells that impair the ability of the fetus to obtain adequate oxygen for proper growth and development and imperil its life and cause the mother extreme fatigue with increased risk of infection.

Q: Why does this anemia imperil the fetus and cause the mother extreme fatigue with increased risk of infection?

A: Severe iron deficiency anemia significantly impedes the ability of the mother’s blood to carry sufficient oxygen for both her needs and the unborn baby’s needs. In this anemia the blood cells do not have adequate hemoglobin which functions to carry oxygen from the mother’s lungs to her body. Of course, the fetus gets its oxygen only from the mother’s blood.

Red blood cell production and function are dependent on a sufficient level of iron in the body and also the ability to use iron to make hemoglobin in red blood cells.

Hemoglobin is a protein that binds oxygen in red blood cells to be carried by the bloodstream to cells throughout the body. In iron deficiency anemia,  hemoglobin in females is below 12.5g/dl (normal range is 12.5g/dl  to 16g/dl ).

What Is Severe Iron Deficiency Anemia In Pregnancy In Celiac Disease and/or Gluten Sensitivity?

What Is Short Duration Of Breast Feeding?

S hort duration of breast feeding, or lactation, is characterized by inadequate milk production by a mother who has just given birth.

Normally, lactation begins with the production and release of colostrum from the mammary glands during the first few days after birth until the milk comes in. Colostrum is a yellow colored, nutrient rich fluid, high in calories and containing immunoglobulins to protect the baby from infection.

Lactation depends on adequate secretion of prolactin hormone by the pituitary gland which begins after the rapid decrease of estrogen and progesterone from the ovaries that occurs with childbirth. Prolactin secretion is afterward stimulated by sucking of the infant and continues as long as the infant nurses.

Milk production to meet the needs of the infant depends on adequate nutrition on the part of the mother.

What Is Short Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity?

What Are Sperm Abnormalities?

S perm abnormalities are the result of gonadal dysfunction (testicles) characterized by inability to either produce sperm or to produce viable sperm or mobile sperm which results in prohibiting fertilization of the female ovum.

Q: How are sperm normally produced?

A: There are two testicles, or testes, that are oblong, egg shapes about 2 inches long and an inch wide and enclosed in a protective sac called the scrotum which hangs outside the body. The testes have these functions:

• Produce and store millions of sperm cells called spermatozoa.
• Produce hormones, including testosterone which stimulate the production of sperm.

What Are Sperm Abnormalities In Celiac Disease and/or Gluten Sensitivity?

What Is Impotence?

I mpotence is an erectile dysfunction disorder in males characterized by the distressing inability to achieve or maintain an erection satisfactory for coitus.

What Is Impotence In Celiac Disease and/or Gluten Sensitivity?

What Is Unexplained Adult Male Hypogonadism?

H ypogonadism in males is a distressing reproductive disorder characterized by inadequate production of male andogen hormones and/or spermatozoa by the testes.

Q: How do andogens affect reproductive health?

A: Male androgen hormones control the development and maintenance of male sex organs and masculine secondary sex characteristics and are required for health, especially bone health. 

Testosterone is the major andogen hormone. While most of this steroid is produced by the testes, some is also produced by the adrenal glands. In hypogonadism, the testosterone level in blood is 300 ng/dl or below. 

Hypogonadism in men 45 years or older is significantly higher in men with hypertension, hyperlipidaemia, diabetes, obesity, prostate disease, and asthma or chronic obstructive pulmonary disease.¹

Interestingly, a 2014 study by Shortridge et al. on experiences and treatment of men with hypogonadism seeking care found that some symptoms continued despite treatment, and therapy was discontinued at a high rate, which men generally attributed to cost and perceptions of efficacy.² Compare this to the reversal seen in celiac men on gluten free diet.

Who is Affected in the General Population? Prevalence rate of hypogonadism was 38.7% in a study of 2162 primary care patients; 836 were hypogonadal, with 80 receiving testosterone.¹

What Is Unexplained Adult Male Hypogonadism In Celiac Disease and/or Gluten Sensitivity?

1. Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006 Jul;60(7):762-9. [↩] [↩]
2. Shortridge EF, Polzer P, Donga P, Blanchette CM, Fang Y, Burudpakdee C, Carswell B. Experiences and treatment patterns of hypogonadal men in a U.S. health system. Int J Clin Pract. 2014 Mar 28. doi: 10.1111/ijcp.12418. [↩]

What Is Infertility in Males?

I nfertility in males is characterized by inability to either produce sperm or to produce viable sperm or mobile sperm resulting in prohibiting fertilization of the female ovum (egg).

To the left is a false-colour scanning electron micrograph of seminiferous tubules in the human testis (cross section), the site of production and maturation of sperm.

Round undifferentiated cells lining the tubule wall (brown, pink) become sperm by halving their chromosome number, and transforming in a process which takes about two months. During this time the cells move toward the centre of the tubule and develop tails (orange). Mature sperm migrate up the cavity of the tubule and are stored in the epididymis. 200-300 million sperm are released in an average ejaculation. Courtesy of Professor P. Motta, Dept.of Anatomy, University of Rome Science Photo Library.

Male androgen hormones control the development and maintenance of male sex organs and masculine secondary sex characteristics and are required for health, especially bone health.

Testosterone is the major andogen hormone. While most of this steroid is produced by the testes, some is also produced by the adrenal glands.

What Is Infertility In Males In Celiac Disease and/or Gluten Sensitivity?