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Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery

International Journal of Obesity volume 39, pages 686–694 (2015)Cite this article

Subjects

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.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Genetics, University of Utah and LiVe Well Center Salt Lake, Intermountain Healthcare, Salt Lake City, UT, USA

    T D Adams

  2. VF Michigan, Bloomfield Hills, MI, USA

    A O Hammoud

  3. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA

    A O Hammoud

  4. Department of Exercise Science, Brigham Young University, Provo, UT, USA

    L E Davidson

  5. Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA

    L E Davidson

  6. Division of Endocrinology, St Luke’s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons and New York Obesity Nutrition Research Center, Diabetes and Nutrition, New York, NY, USA

    B Laferrère

  7. Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    A Fraser

  8. Division of Public Health, University of Utah, Salt Lake City, UT, USA

    J B Stanford, M Hashibe, J L J Greenwood & J Kim

  9. Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, UT, USA

    D Taylor

  10. Department of Obstetrics and Gynecology,

    A J Watson

  11. , University of Utah, Salt Lake City, UT, USA

    A J Watson

  12. Department of Population Sciences, Huntsman Cancer Institute and Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA

    K R Smith

  13. Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA

    R McKinlay, S C Simper & S C Smith

  14. Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA

    S C Hunt

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Correspondence to T D Adams.

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Competing interests

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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