Higher risk of low birth weight and multiple nutritional deficiencies in neonates from mothers after gastric bypass: A case control study - 10/09/15

Doi : 10.1016/j.ando.2015.07.026

G. Gascoin, Dr ^a, M. Gerard, Dr ^a, A. Sallé, Dr ^a, D. Frein, Dr ^a, P. Topart, Dr ^b, G. Becouarn, Dr ^b, F. Schmitt, Dr ^a, C. Briet, Dr ^a, S. Rouleau, Dr ^a, L. Sentilhes, Pr ^a, R. Coutant, Pr ^⁎,^a
^a CHU Angers, Angers, France
^b Clinique de l’Anjou, Angers, France

^⁎Corresponding author.

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Résumé

Background

Maternal bariatric surgery is associated with an increased risk of small-for-gestational-age infants. The risk of nutritional deficiencies in neonates of mothers with prior gastric bypass (GBP) is unclear.

Methods

This study compared the clinical and cord blood biological characteristics of 56 newborns of GBP mothers and 56 newborns of non-obese healthy mothers after normal pregnancy, in the Obstetrics Department of Angers University Hospital between 01/03/2008 and 31/10/2012. After GBP, the women took daily multivitamin and trace element supplements, were followed monthly once pregnant and had blood drawn at delivery for nutritional assessment.

Findings

GBP mothers lost 18.1±6.3kg/m² of BMI in the 11–69 months between surgery and pregnancy onset, reaching BMI of 30.1±6.0kg/m² compared with 22.3±4.0kg/m² in the controls (P<0.05). Birth weight was 0.34kg lower in neonates born to GBP mothers (P<0.01), and 23% were small for gestational age vs. 3.6% in the control group (P<0.01). The odds-ratios (OR) for cord blood concentrations below the 2.5th percentile were significant in GBP neonates for calcium, zinc, iron, vitamin A, and coagulation factors II and X. In contrast, the OR for cord blood concentrations over the 97.5th percentile were significant in GBP neonates for Mg and vitamin E, owing to maternal supplementation.