Fetomaternal outcomes in women with coeliac disease; impact of diet – control, a retrospective cohort study

Background Celiac disease (CD) is an autoimmune enteropathy triggered by gluten in genetically susceptible individuals. Evidence links CD to adverse pregnancy outcomes, yet data from the Middle East are limited. Objective To evaluate pregnancy outcomes in Jordanian women with CD compared to non-CD controls, and to assess the effect of gluten-free diet (GFD) adherence. Methods A retrospective cohort study was conducted at Jordan University Hospital (2019–2024), including 75 women with biopsy/serology-confirmed CD and 72 matched controls. Pregnancy outcomes—miscarriage, stillbirth, low birth weight (LBW), NICU admission, gestational complications, and delivery methods—were analyzed using chi-square tests and logistic regression. Results Women with CD had higher rates of stillbirth (21.3% vs. 8.3%; aOR 2.98, 95% CI 1.09–8.12, p = 0.032) and postpartum hemorrhage (9.3% vs. 1.4%, p = 0.034). Other outcomes, including miscarriage, preterm birth, LBW, and cesarean section, did not differ significantly. Among CD patients, adherence to a strict GFD was associated with a lower risk of NICU admission (30% vs. 58%; aOR 0.31, 95% CI 0.12–0.83, p = 0.020). Conclusion Celiac disease is associated with increased risk of stillbirth and postpartum hemorrhage among Jordanian women. Strict adherence to a GFD may reduce neonatal complications, highlighting the need for early diagnosis, dietary management, and close obstetric monitoring in this population.