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Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group.

Abstract

OBJECTIVE

Roux-en-Y gastric bypass surgery and small-for-gestational-age births are known to be associated although the etiology is not fully understood. This study aimed to investigate pregnancy outcomes and maternal nutritional status among pregnant women with a history of Roux-en-Y gastric bypass using maternal anemia and gestational weight gain as indicators of micronutrient and macronutrient deficiency in pregnancy.

STUDY DESIGN

The study was designed as a retrospective matched cohort study. All Roux-en-Y-gastric-bypass-operated pregnant women (n=151) who were followed in the outpatient obstetric clinic at Aalborg University Hospital in Denmark and gave birth between 1 January 2010 and 31 December 2013 were included. Each Roux-en-Y-gastric-bypass-operated woman was closely matched with a non-Roux-en-Y-gastric-bypass-operated woman. Primary outcomes were small-for-gestational-age birth, maternal anemia and gestational weight gain. The two groups (matched 1:1) were compared by paired tests on all measures, conditional logistic regression for paired binary data and the paired t-test or Wilcoxon signed-rank test for paired continuous data.

RESULTS

The risk of small-for-gestational-age birth (odds ratio (OR)=2.67, 95% confidence interval (CI); 1.04-6.82) and maternal anemia (OR=3.0, 95% CI; 1.09-8.25) were significantly increased for the Roux-en-Y gastric bypass group compared to the non-Roux-en-Y gastric bypass group. No significant difference was found in gestational weight gain (p=0.169) between women with a history of Roux-en-Y gastric bypass (11.51kg±8.97 standard deviation (SD)) and non- Roux-en-Y-gastric-bypass-operated women (12.18kg±6.28 SD).

CONCLUSION

A history of Roux-en-Y gastric bypass surgery increases the risk of small-for-gestational-age birth and anemia, while a finding of differences in gestational weight gain is uncorroborated. Our findings suggest a role of micronutrient deficiency rather than reduced gestational weight gain in the etiology of small-for-gestational-age birth among women with a history of Roux-en-Y gastric bypass surgery.

Authors+Show Affiliations

Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. Electronic address: hammekenlianna@gmail.com.Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark.Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark.Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28732251

Citation

Hammeken, Lianna Hede, et al. "Nutrient Deficiency and Obstetrical Outcomes in Pregnant Women Following Roux-en-Y Gastric Bypass: a Retrospective Danish Cohort Study With a Matched Comparison Group." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 216, 2017, pp. 56-60.
Hammeken LH, Betsagoo R, Jensen AN, et al. Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group. Eur J Obstet Gynecol Reprod Biol. 2017;216:56-60.
Hammeken, L. H., Betsagoo, R., Jensen, A. N., Sørensen, A. N., & Overgaard, C. (2017). Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 216, pp. 56-60. doi:10.1016/j.ejogrb.2017.07.016.
Hammeken LH, et al. Nutrient Deficiency and Obstetrical Outcomes in Pregnant Women Following Roux-en-Y Gastric Bypass: a Retrospective Danish Cohort Study With a Matched Comparison Group. Eur J Obstet Gynecol Reprod Biol. 2017;216:56-60. PubMed PMID: 28732251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group. AU - Hammeken,Lianna Hede, AU - Betsagoo,Ramsina, AU - Jensen,Ann Nygaard, AU - Sørensen,Anne Nødgaard, AU - Overgaard,Charlotte, Y1 - 2017/07/12/ PY - 2017/01/18/received PY - 2017/07/03/revised PY - 2017/07/10/accepted PY - 2017/7/22/pubmed PY - 2018/5/22/medline PY - 2017/7/22/entrez KW - Anemia KW - Bariatric surgery KW - Gastric bypass KW - Pregnancy KW - Small-for-gestational-age SP - 56 EP - 60 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 216 N2 - OBJECTIVE: Roux-en-Y gastric bypass surgery and small-for-gestational-age births are known to be associated although the etiology is not fully understood. This study aimed to investigate pregnancy outcomes and maternal nutritional status among pregnant women with a history of Roux-en-Y gastric bypass using maternal anemia and gestational weight gain as indicators of micronutrient and macronutrient deficiency in pregnancy. STUDY DESIGN: The study was designed as a retrospective matched cohort study. All Roux-en-Y-gastric-bypass-operated pregnant women (n=151) who were followed in the outpatient obstetric clinic at Aalborg University Hospital in Denmark and gave birth between 1 January 2010 and 31 December 2013 were included. Each Roux-en-Y-gastric-bypass-operated woman was closely matched with a non-Roux-en-Y-gastric-bypass-operated woman. Primary outcomes were small-for-gestational-age birth, maternal anemia and gestational weight gain. The two groups (matched 1:1) were compared by paired tests on all measures, conditional logistic regression for paired binary data and the paired t-test or Wilcoxon signed-rank test for paired continuous data. RESULTS: The risk of small-for-gestational-age birth (odds ratio (OR)=2.67, 95% confidence interval (CI); 1.04-6.82) and maternal anemia (OR=3.0, 95% CI; 1.09-8.25) were significantly increased for the Roux-en-Y gastric bypass group compared to the non-Roux-en-Y gastric bypass group. No significant difference was found in gestational weight gain (p=0.169) between women with a history of Roux-en-Y gastric bypass (11.51kg±8.97 standard deviation (SD)) and non- Roux-en-Y-gastric-bypass-operated women (12.18kg±6.28 SD). CONCLUSION: A history of Roux-en-Y gastric bypass surgery increases the risk of small-for-gestational-age birth and anemia, while a finding of differences in gestational weight gain is uncorroborated. Our findings suggest a role of micronutrient deficiency rather than reduced gestational weight gain in the etiology of small-for-gestational-age birth among women with a history of Roux-en-Y gastric bypass surgery. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/28732251/Nutrient_deficiency_and_obstetrical_outcomes_in_pregnant_women_following_Roux_en_Y_gastric_bypass:_A_retrospective_Danish_cohort_study_with_a_matched_comparison_group_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(17)30348-2 DB - PRIME DP - Unbound Medicine ER -