All the participants at the convention in the 15-49 age group, accepted to be enrolled in the study. A total number of 62 interviews of celiac women (average age: 33.2 ± 9.7, 95% CI: 30.7-35.7) were collected. The response rate was 100%. 35.5% of the women resided in the province of Bari, 30.6% in the province of Foggia, 14.5% in the province of Lecce, 12.9% in the province of Taranto, 4.8% in the province of BAT, 1.6% in the province of Brindisi (Table ). Three age-matched and town of residence-matched controls were interviewed for each celiac woman: a total number of 186 interviews were collected with a replacement rate of about 15%. The commonest reason for replacement was refusal to join the study. The average age of controls (32.8 ± 9.9 years, 95% CI: 31.4-34.3) and their distribution per province turned out to overlap those of celiac women (Table ).
Sample description, by age classes and provinces of residence.
In 100% of cases (n = 62) the diagnosis of celiac disease had been made by a medical specialist: the serum levels of anti-gliadin antibodies (AGA) had been measured in 58.1% of the cases of celiac disease (n = 36), anti-endomysial antibodies (AEA) had been assessed in 56.5% of celiac women (n = 35), and anti-transglutamminase antibodies (anti-tTG) had been dosed in 41.9% (n = 26) of them. 41.9% (n = 26) of the celiac women interviewed had undergone small intestine biopsy. In one case HLA genomic typing for DQ2/DQ8 had been performed.
The average age at the diagnosis of celiac disease of the women interviewed turned out to be 24.2 ± 13.57 (95% CI: 20.7-27.6; range: 1 year - 47 years).
In 69.3% (n = 43) of cases the onset symptom had been "bloated stomach", in 61.3% (n = 38) it had been "anaemia", in 51.6% (n = 32) "weight loss", in 40.3% (n = 25) "diarrhea", in 17.7% (n = 11) "vomiting"; 40.3% (n = 25) of cases had presented with "other symptoms/signs" including "menstrual cycle disorders" (4.8% of cases). 8.1% (n = 5) of celiac women reported that more than four symptoms were present at the onset of their disease, whereas in 45.2% (n = 30) of them onset symptoms/signs had been three or four and one or two in 46.7% (n = 29).
At the time of the interview 98.4% (n = 61) of the celiac women had been on a gluten free diet (GFD) for on average 7.9 ± 7.8 years (95% CI: 6-10 years).
The average age at menarche of celiac women was 12.7 ± 1.4 years (95% CI: 12.3-13.0), overlapping that of controls (12.4 ± 1.4 years; 95% CI: 12.2-12.6, p = 0.1838).
67.7% (n = 42) of celiac women and 64.5% (n = 120) of controls reported a past history of at least one menstrual cycle disorder (p = 0.6456). Table reports menstrual cycle disorders prevalence.
Menstrual cycle disorders prevalence (OR and 95% CI).
Gestational disorders prevalence (OR and 95% CI).
47.6% (n = 20) of the women with celiac disease who reported they had suffered from menstrual cycle disorders had observed the onset of these latter "before" that of other celiac disease-ascribable symptoms/signs; 28.6% of them had seen the onset of the same menstrual cycle disorders "after" other celiac disease-traceable symptoms/signs; whereas in 19% (n = 8) of celiac women menstrual cycle disorders had appeared "concurrently" with other symptoms/signs (Figure ). Two celiac women did not specify any time relation between celiac disease-ascribable symptoms/signs and menstrual cycle disorders. 26.2% (n = 11) of celiac women who reported menstrual cycle disorders had received a diagnosis of celiac disease "before" the onset of the same menstrual cycle disorders; whereas 69.1% of them had been diagnosed celiac disease "after" the onset of menstrual cycle disorders, in one case only diagnosis and onset of menstrual cycle disorders had been "concurrent" (Figure ). One celiac woman did not specify any time relation between the onset of menstrual cycle disorders and celiac disease diagnosis. 73.8% (n = 31) of celiac women were not on a gluten free diet at the onset of the menstrual cycle disorders reported.
Proportion of cases referring menstrual cycle disorders, by onset time of menstrual cycle disorders over onset time of the pathognomonic symptoms/signs of celiac disease and onset time of celiac disease diagnosis.
At the time of the interview 41.9% (n = 26) of celiac women and 51.1% (n = 95) of controls reported they still suffered from menstrual cycle disorders (p = 0.2140).
50% (n = 31) of celiac women and 50% (n = 93) of controls had had one or more pregnancies. Celiac women reported a total number of 63 pregnancies, 49 (77.8%) of which had been brought to full term, while controls reported a total of 203 pregnancies, 179 (88.2%) of which had been brought to full term. 22.2% (n = 14) of the pregnancies of celiac women had ended in a miscarriage versus 11.8% (n = 24) of the pregnancies of controls (OR = 2.1, 95% CI = 0.9-4.6; χ2 = 4.2, p = 0.0393).
In 65.3% (n = 32) of the celiac women full term pregnancies at least one gestational disorder was reported versus 31.3% (n = 56) in the full term pregnancies of controls (OR = 4.1, 95% CI = 2-8.6; χ2 = 18.8, p = 0.000). Table and Figure report gestational disorders prevalence and proportion of pregnancies, by gestational disorder respectively.
Proportion of pregnancies, by gestational disorder.
28.6% (n = 6) of the celiac women who reported problems during pregnancies had exhibited celiac disease-ascribable symptoms/signs before their first pregnancy; 38.1% (n = 8) reported problems "after" their first pregnancy and 28.6% (n = 6) had had their symptoms/signs "concurrently" with their first pregnancy (Figure ). One of the celiac women did not specify any time relation between celiac disease-ascribable symptoms and her first pregnancy.
Proportion of cases referring gestational disorders, by time of onset of celiac disease pathognomonic symptoms/signs and celiac disease diagnosis.
14.3% (n = 3) of the celiac women with pregnancy problems had been diagnosed with CD before their first pregnancy, while 85.7% (n = 21) of them had received their diagnosis "after" their first pregnancy (Figure ). A gluten free diet had been followed during 15 pregnancies (23.8%).
Gestation duration in celiac women was on average 38.5 ± 2.6 weeks (95% CI: 37.7-39.2), versus 40.5 ± 3.6 weeks (95% CI: 39.9-41; t = 3.6, p = 0.000) in healthy controls.
The average birth weight of the children of the celiac women (2956.7 ± 587.3 grams, 95% CI: 2788.0-3125.4) was lower than that of the children of healthy controls (3271.6 ± 637.6 grams, 95% CI: 3177.5-3365.6; t = 3.1, p = 0.000).
The percentage of breastfed babies has been observed to overlap between celiac women (81.6%) and healthy controls (79.3%; OR: 1.2, 95% CI: 0.5-3; χ2 = 0.36, p = 0.5499), whereas the duration of breastfeeding has been found to be shorter (146.4 ± 104.7 days, 95% CI: 112.9-179.9) in celiac women compared to that of healthy women (229.8 ± 177.7 days, 95% CI: 200.4-259.4; t = 2.8, p = 0.008).