Abstract
Background:
Interaction between maternal obesity, intrauterine environment and adverse clinical outcomes of newborns has been described.
Methods:
Using statewide birth certificate data, this retrospective, matched-control cohort study compared paired birth weights and complications of infants born to women before and after Roux-en-Y gastric bypass surgery (RYGB) and to matched obese non-operated women in several different groups. Women who had given birth to a child before and after RYGB (group 1; n=295 matches) and women with pregnancies after RYGB (group 2; n=764 matches) were matched to non-operated women based on age, body mass index (BMI) prior to both pregnancy and RYGB, mother’s race, year of mother/s birth, date of infant births and birth order. In addition, birth weights of 13 143 live births before and/or after RYGB of their mothers (n=5819) were compared (group 3).
Results:
Odds ratios (ORs) for having a large-for-gestational-age (LGA) neonate were significantly less after RYGB than for non-surgical mothers: ORs for groups 1 and 2 were 0.19 (0.08–0.38) and 0.33 (0.21–0.51), respectively. In contrast, ORs in all three groups for risk of having a small for gestational age (SGA) neonate were greater for RYGB mothers compared to non-surgical mothers (ORs were 2.16 (1.00–5.04); 2.16 (1.43–3.32); and 2.25 (1.89–2.69), respectively). Neonatal complications were not different for group 1 RYGB and non-surgical women for the first pregnancy following RYGB. Pregnancy-induced hypertension and gestational diabetes were significantly lower for the first pregnancy of mothers following RYGB compared to matched pregnancies of non-surgical mothers.
Conclusion:
Women who had undergone RYGB not only had lower risk for having an LGA neonate compared to BMI-matched mothers, but also had significantly higher risk for delivering an SGA neonate following RYGB. RYGB women were less likely than non-operated women to have pregnancy-related hypertension and diabetes.
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Acknowledgements
This study was supported by NIH R01-DK-55006, M01-RR00064, NIH R01-AG-022095 and by the Huntsman Cancer Institute. Partial support for all datasets within the Utah Population Database was provided by the Huntsman Cancer Institute.
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TDA received partial funding through the Huntsman Fellowship—Advancing Community Cancer Prevention, Intermountain Research and Medical Foundation and Intermountain Healthcare Corporation, Inc. All other authors declare no conflict of interest.
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Adams, T., Hammoud, A., Davidson, L. et al. Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. Int J Obes 39, 686–694 (2015). https://doi.org/10.1038/ijo.2015.9
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DOI: https://doi.org/10.1038/ijo.2015.9
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