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

T. D. Adams, A. O. Hammoud, L. E. Davidson, B. Laferrère, A. Fraser, J. B. Stanford, M. Hashibe, J. L J Greenwood, J. Kim, D. Taylor, A. J. Watson, K. R. Smith, R. McKinlay, S. C. Simper, S. C. Smith, Steven Hunt

Research output: Contribution to journalArticle

22 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)686-694
Number of pages9
JournalInternational Journal of Obesity
Volume39
Issue number4
DOIs
Publication statusPublished - 9 Apr 2015
Externally publishedYes

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Gastric Bypass
Pregnancy Outcome
Mothers
Pregnancy
Gestational Age
Newborn Infant
Odds Ratio
Gestational Diabetes
Parturition
Birth Weight
Body Mass Index
Birth Certificates
Pregnancy Induced Hypertension
Birth Order
Live Birth
Cohort Studies
Obesity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Adams, T. D., Hammoud, A. O., Davidson, L. E., Laferrère, B., Fraser, A., Stanford, J. B., ... Hunt, S. (2015). Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. International Journal of Obesity, 39(4), 686-694. https://doi.org/10.1038/ijo.2015.9

Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. / Adams, T. D.; Hammoud, A. O.; Davidson, L. E.; Laferrère, B.; Fraser, A.; Stanford, J. B.; Hashibe, M.; Greenwood, J. L J; Kim, J.; Taylor, D.; Watson, A. J.; Smith, K. R.; McKinlay, R.; Simper, S. C.; Smith, S. C.; Hunt, Steven.

In: International Journal of Obesity, Vol. 39, No. 4, 09.04.2015, p. 686-694.

Research output: Contribution to journalArticle

Adams, TD, Hammoud, AO, Davidson, LE, Laferrère, B, Fraser, A, Stanford, JB, Hashibe, M, Greenwood, JLJ, Kim, J, Taylor, D, Watson, AJ, Smith, KR, McKinlay, R, Simper, SC, Smith, SC & Hunt, S 2015, 'Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery', International Journal of Obesity, vol. 39, no. 4, pp. 686-694. https://doi.org/10.1038/ijo.2015.9
Adams TD, Hammoud AO, Davidson LE, Laferrère B, Fraser A, Stanford JB et al. Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. International Journal of Obesity. 2015 Apr 9;39(4):686-694. https://doi.org/10.1038/ijo.2015.9
Adams, T. D. ; Hammoud, A. O. ; Davidson, L. E. ; Laferrère, B. ; Fraser, A. ; Stanford, J. B. ; Hashibe, M. ; Greenwood, J. L J ; Kim, J. ; Taylor, D. ; Watson, A. J. ; Smith, K. R. ; McKinlay, R. ; Simper, S. C. ; Smith, S. C. ; Hunt, Steven. / Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. In: International Journal of Obesity. 2015 ; Vol. 39, No. 4. pp. 686-694.
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AU - Stanford, J. B.

AU - Hashibe, M.

AU - Greenwood, J. L J

AU - Kim, J.

AU - Taylor, D.

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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.

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