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Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery.
Int J Obes (Lond). 2015 Apr; 39(4):686-94.IJ

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.

Authors+Show Affiliations

Division of Cardiovascular Genetics, University of Utah and LiVe Well Center Salt Lake, Intermountain Healthcare, Salt Lake City, UT, USA.1] VF Michigan, Bloomfield Hills, MI, USA [2] Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.1] Department of Exercise Science, Brigham Young University, Provo, UT, USA [2] Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA.St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons and New York Obesity Nutrition Research Center, Division of Endocrinology, Diabetes and Nutrition, New York, NY, USA.Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.Division of Public Health, University of Utah, Salt Lake City, UT, USA.Division of Public Health, University of Utah, Salt Lake City, UT, USA.Division of Public Health, University of Utah, Salt Lake City, UT, USA.Division of Public Health, University of Utah, Salt Lake City, UT, USA.Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, UT, USA.Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.Department of Population Sciences, Huntsman Cancer Institute and Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA.Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25644056

Citation

Adams, T D., et al. "Maternal and Neonatal Outcomes for Pregnancies Before and After Gastric Bypass Surgery." International Journal of Obesity (2005), vol. 39, no. 4, 2015, pp. 686-94.
Adams TD, Hammoud AO, Davidson LE, et al. Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. Int J Obes (Lond). 2015;39(4):686-94.
Adams, T. D., Hammoud, A. O., Davidson, L. E., Laferrère, B., Fraser, A., Stanford, J. B., Hashibe, M., Greenwood, J. L., Kim, J., Taylor, D., Watson, A. J., Smith, K. R., McKinlay, R., Simper, S. C., Smith, S. C., & Hunt, S. C. (2015). Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. International Journal of Obesity (2005), 39(4), 686-94. https://doi.org/10.1038/ijo.2015.9
Adams TD, et al. Maternal and Neonatal Outcomes for Pregnancies Before and After Gastric Bypass Surgery. Int J Obes (Lond). 2015;39(4):686-94. PubMed PMID: 25644056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. AU - Adams,T D, AU - Hammoud,A O, AU - Davidson,L E, AU - Laferrère,B, AU - Fraser,A, AU - Stanford,J B, AU - Hashibe,M, AU - Greenwood,J L J, AU - Kim,J, AU - Taylor,D, AU - Watson,A J, AU - Smith,K R, AU - McKinlay,R, AU - Simper,S C, AU - Smith,S C, AU - Hunt,S C, Y1 - 2015/02/03/ PY - 2014/09/09/received PY - 2014/12/17/revised PY - 2014/12/25/accepted PY - 2015/2/4/entrez PY - 2015/2/4/pubmed PY - 2016/1/27/medline SP - 686 EP - 94 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 39 IS - 4 N2 - 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. SN - 1476-5497 UR - https://www.unboundmedicine.com/medline/citation/25644056/Maternal_and_neonatal_outcomes_for_pregnancies_before_and_after_gastric_bypass_surgery_ L2 - http://dx.doi.org/10.1038/ijo.2015.9 DB - PRIME DP - Unbound Medicine ER -