Abstract
Objective
The aim of the study is to explore the impact of time between Roux-en-Y gastric bypass (RYGB) and pregnancy on obstetrical outcome and nutritional derangements.
Methods
In a retrospective cross-sectional study of pregnant women admitted for antenatal care at two tertiary hospitals, we examined 153 women with RYGB and a singleton pregnancy of at least 24 weeks. The women were stratified according to a pregnancy <18 months (40 women) or ≥18 months (113 women) after RYGB. Main outcome measures were nutritional parameters and glycated haemoglobin 1Ac (HbA1c) in second and third trimester of pregnancy, gestational hypertension, length of pregnancy, mode of delivery and foetal birth weight.
Results
The two groups were comparable regarding age, parity and prepregnancy body mass index. The frequency of iron deficiency anaemia (ferritin <12 μg/L and haemoglobin <6.5 mmol/L/10.5 g/dL) was significantly higher in the late group, 29 vs. 8 % in the early group, p = 0.010. No differences were found for vitamin B12, vitamin D and zinc. Median HbA1c was significantly higher in the late group than in the early group (33 vs. 31 mmol/mol, p = 0.027). There were no significant differences in the risk of adverse pregnancy outcome or birth weight between the two groups.
Conclusion
A long surgery-to-pregnancy time interval after a RYGB increases the risk of iron deficiency anaemia but not of other nutritional deficits. Time interval does not seem to have an adverse effect on the obstetrical outcome, including intrauterine growth restriction. Specific attention is needed on iron deficit with increasing surgery-to-pregnancy time interval.
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Abbreviations
- BMI:
-
Body mass index
- CS:
-
Caesarean section
- GDM:
-
Gestational diabetes mellitus
- HbA1c:
-
Haemoglobin A1c
- LGA:
-
Large for gestational age
- PE:
-
Preeclampsia
- PIH:
-
Pregnancy-induced hypertension
- RYGB:
-
Roux-en-Y gastric bypass
- SGA:
-
Small for gestational age
- GA:
-
Gestational age
- IFCC:
-
International Federation of Clinical Chemistry
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Acknowledgments
The authors would like to acknowledge the contribution of Frida Nilsson, doctor at Department of Orthopaedic Surgery, Visby Hospital, Sweden for her help in finding and screening the journals of the included women of the cohort; Mette Visholm, secretary at the Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Denmark, for her help with retrieving medical records; and Steen Rasmussen for his help in gathering data from a regional database.
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The Danish board of Data Protection approved the study (Journal Number 2012-41-1006).
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The authors declare that they have no conflict of interest.
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Crusell, M., Nilas, L., Svare, J. et al. A Time Interval of More Than 18 Months Between a Pregnancy and a Roux-en-Y Gastric Bypass Increases the Risk of Iron Deficiency and Anaemia in Pregnancy. OBES SURG 26, 2457–2462 (2016). https://doi.org/10.1007/s11695-016-2130-3
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DOI: https://doi.org/10.1007/s11695-016-2130-3