Neonatal Outcomes of Pregnancy Following Roux-en-Y Gastric Bypass: a Matched Case-Control Study
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ORIGINAL CONTRIBUTIONS
Neonatal Outcomes of Pregnancy Following Roux-en-Y Gastric Bypass: a Matched Case-Control Study Brenda M. Machado 1 & Carina A. Blume 2 & Cláudio C. Mottin 3,4 & Michele Drehmer 5 & Beatriz D. Schaan 2,6
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To compare perinatal outcomes and to assess the predictors of birth weight (BW) after Roux-en-Y gastric bypass (RYGB) to those women unexposed to bariatric surgery. Materials and Methods Singleton births from women submitted to RYGB (BSG) were matched to two control births by maternal age, delivery year, and gender. Control group 1 (CG1) and control group 2 (CG2) were selected according to the prepregnancy body mass index (BMI) < 35 kg/m2 and ≥ 35 kg/m2, respectively, without previous bariatric surgery. Results Fifty-eight pregnancies were evaluated in each group (n = 174). Neonates born after RYGB presented lower BW compared to CG1 (mean difference − 182.3 g; 95% CI − 333; − 31, P = 0.018) and CG2 (mean difference − 306.6 g, 95% CI − 502; − 111, P = 0.02). Although gestational age (GA) was similar (P = 0.219), fetal growth rate (in grams) per gestational week was higher in CG2 (β = 196.27, P < 0.001) vs. BSG (β = 127.65, P < 0.001), irrespective of gestational weight gain (GWG). Pregnancies post-RYGB showed lower GWG, lower BW, and higher prevalence of cesarean section than CG1 and were associated with lower BW, smaller cephalic perimeter, lower prevalence of macrosomia, hypertension, and gestational diabetes than CG2. Conclusion Birth weight was higher in neonates from women with higher prepregnancy BMI, as compared to births from women submitted to RYGB, irrespective of GWG. Although nearly half of the RYGB mothers were classified with obesity at conception, those pregnancies were associated with better obstetric and neonatal outcomes than among women with prepregnancy BMI ≥ 35 kg/m2 who had never undergone RYGB. Keywords Bariatric surgery . Roux-en-Y gastric bypass . Birth weight . Gestational weight gain . Gestational age
* Beatriz D. Schaan [email protected] Brenda M. Machado [email protected] Carina A. Blume [email protected] Cláudio C. Mottin [email protected] Michele Drehmer [email protected] 1
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
2
Postgraduate Program in Medical Sciences, Endocrinology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
3
Center for Obesity and Metabolic Syndrome, Hospital São Lucas da Pontifícia, Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
4
School of Medicine, PUCRS, Porto Alegre, RS, Brazil
5
Department of Nutrition, Postgraduate Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
6
Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Prédio 12 - 4° andar, Porto Alegre 90035-003, RS, Brazil
OBES SURG
Introduction Maternal obesi
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