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Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review.

Abstract

Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was conducted independently by 2 researchers to examine deficiencies of phylloquinone, folate, iron, calcium, zinc, magnesium, iodide, copper, and vitamins A, D, and B-12 in pregnant and postpartum women after bariatric surgery, together with subsequent outcomes in the neonates. The search identified 29 relevant cases and 8 cohort studies. The quality of reporting among the case reports was weak according to the criteria based on the CARE (CAse REporting) guidelines as was that for the cohort studies based on the criteria from the Cohort Study Quality Assessment list of the Dutch Cochrane Center. The most common adverse neonatal outcomes related to maternal micronutrient deficiencies include visual complications (vitamin A), intracranial hemorrhage (phylloquinone), neurological and developmental impairment (vitamin B-12), and neural tube defects (folate). On the basis of the systematically collected information, we conclude that the evidence on micronutrient deficiencies in pregnant and postpartum women after bariatric surgery and subsequent adverse neonatal outcomes remains weak and inconclusive.

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  • Authors+Show Affiliations

    ,

    Departments of Development and Regeneration and.

    ,

    Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Departments of Endocrinology.

    ,

    University College Leuven, Hasselt, Belgium; Center for Research and Innovation in Care, Department of Nursing and Midwifery Sciences, University of Antwerp, Antwerp, Belgium; and.

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    Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Abdominal Surgery, and.

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    Departments of Development and Regeneration and Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium;

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    Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium; Departments of Endocrinology.

    Departments of Development and Regeneration and Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics, Gynecology, and Reproduction, GZA, Wilrijk, Belgium roland.devlieger@uzleuven.be.

    Source

    MeSH

    Bariatric Surgery
    Cohort Studies
    Female
    Folic Acid Deficiency
    Humans
    Infant, Newborn
    Infant, Newborn, Diseases
    Intracranial Hemorrhages
    Micronutrients
    Neural Tube Defects
    Pregnancy
    Pregnancy Complications
    Pregnancy Outcome
    Vision Disorders
    Vitamin A Deficiency
    Vitamin B 12 Deficiency

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    26178026

    Citation

    Jans, Goele, et al. "Maternal Micronutrient Deficiencies and Related Adverse Neonatal Outcomes After Bariatric Surgery: a Systematic Review." Advances in Nutrition (Bethesda, Md.), vol. 6, no. 4, 2015, pp. 420-9.
    Jans G, Matthys C, Bogaerts A, et al. Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. Adv Nutr. 2015;6(4):420-9.
    Jans, G., Matthys, C., Bogaerts, A., Lannoo, M., Verhaeghe, J., Van der Schueren, B., & Devlieger, R. (2015). Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. Advances in Nutrition (Bethesda, Md.), 6(4), pp. 420-9. doi:10.3945/an.114.008086.
    Jans G, et al. Maternal Micronutrient Deficiencies and Related Adverse Neonatal Outcomes After Bariatric Surgery: a Systematic Review. Adv Nutr. 2015;6(4):420-9. PubMed PMID: 26178026.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. AU - Jans,Goele, AU - Matthys,Christophe, AU - Bogaerts,Annick, AU - Lannoo,Matthias, AU - Verhaeghe,Johan, AU - Van der Schueren,Bart, AU - Devlieger,Roland, Y1 - 2015/07/15/ PY - 2015/7/17/entrez PY - 2015/7/17/pubmed PY - 2016/4/14/medline KW - bariatric surgery KW - early postpartum KW - gestation KW - maternal nutrition KW - micronutrients KW - neonatal complications KW - obesity surgery KW - pregnancy SP - 420 EP - 9 JF - Advances in nutrition (Bethesda, Md.) JO - Adv Nutr VL - 6 IS - 4 N2 - Pregnant and postpartum women with a history of bariatric surgery are at risk of micronutrient deficiencies as a result of the combination of physiologic changes related to pregnancy and iatrogenic postoperative alterations in the absorption and metabolism of crucial nutrients. This systematic review investigates micronutrient deficiencies and related adverse clinical outcomes in pregnant and postpartum women after bariatric surgery. A systematic approach involving critical appraisal was conducted independently by 2 researchers to examine deficiencies of phylloquinone, folate, iron, calcium, zinc, magnesium, iodide, copper, and vitamins A, D, and B-12 in pregnant and postpartum women after bariatric surgery, together with subsequent outcomes in the neonates. The search identified 29 relevant cases and 8 cohort studies. The quality of reporting among the case reports was weak according to the criteria based on the CARE (CAse REporting) guidelines as was that for the cohort studies based on the criteria from the Cohort Study Quality Assessment list of the Dutch Cochrane Center. The most common adverse neonatal outcomes related to maternal micronutrient deficiencies include visual complications (vitamin A), intracranial hemorrhage (phylloquinone), neurological and developmental impairment (vitamin B-12), and neural tube defects (folate). On the basis of the systematically collected information, we conclude that the evidence on micronutrient deficiencies in pregnant and postpartum women after bariatric surgery and subsequent adverse neonatal outcomes remains weak and inconclusive. SN - 2156-5376 UR - https://www.unboundmedicine.com/medline/citation/26178026/full_citation L2 - https://academic.oup.com/advances/article-lookup/doi/10.3945/an.114.008086 DB - PRIME DP - Unbound Medicine ER -