Risk of low birth weight and micronutrient deficiencies in neonates from mothers after gastric bypass: A case control study ☆
Surgery for Obesity and Related Diseases. online 27 March 2017, http://dx.doi.org/10.1016/j.soard.2017.03.017
Geraldine Gascoin, M.D., Ph.D.a, e, 1, Maxime Gerard, M.D.a, 1, Agnès Sallé, M.D., Ph.D.b, c, Guillaume Becouarn, M.D.c, d, Stephanie Rouleau, M.D.a, Loïc Sentilhes, M.D., Ph.D.f, Régis Coutant, M.D.a, c, ,
Background: An increased risk of small-for-gestational-age infants after maternal bariatric surgery has been shown. The risk of micronutrients deficiencies in these neonates is unclear.
Objective: To screen for micronutrients deficiencies in newborns of mothers with gastric bypass
Settings: University Hospital in Angers, France
Methods: This study compared the clinical and cord blood biological characteristics of 56 newborns of mothers with prior gastric bypass (RYGB) and 56 newborns of non-obese healthy mothers after normal pregnancy (controls), followed between 01/03/2008 and 31/10/2012. Cord blood micronutrients concentrations from controls were used for establishing normative data. After RYGB, the women took daily micronutrients supplements.
Results: RYGB mothers lost 18.1±6.3 kg/m2 of Body Mass Index (BMI) in the 11-69 months between surgery and pregnancy onset (percentage of excess weight loss 79±20%), reaching BMI of 30.1±6.0 kg/m2 compared with 22.3±4.0 kg/m2 in the controls (p<0.05).
Neonates born to RYGB mothers were small-for-gestational-age in 23% of cases vs. 3.6% in the control group (p<0.01).
A higher percentage of RYGB neonates had cord blood concentrations
below the 2.5th percentile for
- calcium (19% vs 2%),
- zinc (13% vs 3%,),
- iron (19% vs 2%), and
- vitamin A (13% vs 3%), and
over the 97.5th percentile for
- magnesium (13% vs 3%),
- vitamin E (16% vs 3%),
- 25-hydroxy-vitamin D (13% vs 2%), and
- vitamin B12 (14% vs 2%)(p<0.05 for all comparisons).
Conclusion: Neonates from RYGB mothers showed cord blood micronutrient differences as compared to neonates from healthy mothers. The comparison with neonates from morbidly obese women is still to be done.
Funding: None. The record of medical information as well as the maternal and cord blood analyses were supported by the French national health security system, as part of the usual care.
Correspondence: Régis Coutant, M.D., Department of Pediatrics, University Hospital, 4 rue Larrey, 49000 Angers, France. Tel.: +0033241355655; fax: +0033241354173.