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Archives of Gynecology and Obstetrics

, Volume 300, Issue 5, pp 1253–1259 | Cite as

Offspring of women following bariatric surgery and those of patients with obesity are at an increased risk for long-term pediatric endocrine morbidity

  • Pinhas DamtiEmail author
  • Michael Friger
  • Daniella Landau
  • Ruslan Sergienko
  • Eyal Sheiner
Maternal-Fetal Medicine
  • 78 Downloads

Abstract

Objective

To assess whether offspring of women following bariatric surgery as well as offspring of obese women are at an increased risk for long-term pediatric endocrine morbidity.

Setting

This study was conducted at the university hospital.

Methods

A population-based cohort study compared the incidence of long-term (up to the age of 18 years) occurrence of endocrine morbidity between offspring of mothers following bariatric surgery and obese mothers, as compared with parturients without obesity and without prior bariatric surgery.

Results

During the study period 220,563 newborns met the inclusion criteria; 1001 were delivered by patients following bariatric surgery, 2275 were delivered by obese women and 217,287 were delivered by normal weight women without prior bariatric surgery. Long-term endocrine morbidity was more common in the bariatric group (2.3%) and the obesity group (1.5%) as compared with the comparison group (0.5%; P < 0.001). Specifically, pediatric obesity was significantly more common in children of mothers following bariatric surgery (1.8%) and of mothers with obesity (1.2%) as compared with the comparison group (0.2%; P < 0.001). Children born to women following bariatric surgery as well as obese women had higher cumulative incidence of pediatric endocrine morbidity (Log rank, P < 0.001). The results remained significant when controlling for maternal factors, adjusted HR 6.25, 95% CI 4.10–9.50; P < 0.001 for women following bariatric surgery and aHR 2.40 95% CI 1.69–3.40; P < 0.001 for obese women.

Conclusion

Offspring of women following bariatric surgery as well as those of obese women are at an increased risk for long-term pediatric endocrine morbidity.

Keywords

Bariatric surgery Obesity Pediatric outcome Long-term outcome Endocrine Morbidity 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no commercial associations that might be a conflict of interest in relation to this article.

Supplementary material

404_2019_5322_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 22 kb)

References

  1. 1.
    Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384(9945):766–781CrossRefGoogle Scholar
  2. 2.
    Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML et al (2011) The global obesity pandemic: shaped by global drivers and local environments. Lancet 378(9793):804–814CrossRefGoogle Scholar
  3. 3.
    Metwally M, Ong KJ, Ledger WL, Li TC (2008) Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril 90(3):714–726CrossRefGoogle Scholar
  4. 4.
    Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW et al (2001) Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 25(8):1175–1182CrossRefGoogle Scholar
  5. 5.
    McDonald SD, Han Z, Mulla S, Beyene J, Knowledge Synthesis Group (2010) Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ 341:c3428CrossRefGoogle Scholar
  6. 6.
    Cnattingius S, Bergström R, Lipworth L, Kramer MS (1998) Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 338(3):147–152CrossRefGoogle Scholar
  7. 7.
    Ehrenberg HM, Mercer BM, Catalano PM (2004) The influence of obesity and diabetes on the prevalence of macrosomia. Obstet Gynecol 191(3):964–968Google Scholar
  8. 8.
    Gilead R, Yaniv Salem S, Sergienko R, Sheiner E (2012) Maternal, “isolated” obesity and obstetric complications. J Matern Fetal Neonat Med 25(12):2579–2582CrossRefGoogle Scholar
  9. 9.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292(14):1724–1737CrossRefGoogle Scholar
  10. 10.
    Karmon A, Sheiner E (2008) Pregnancy after bariatric surgery: a comprehensive review. Arch Gynecol Obstet 277(5):381–388CrossRefGoogle Scholar
  11. 11.
    Santry HP, Gillen DL, Lauderdale DS (2005) Trends in bariatric surgical procedures. JAMA 294(15):1909–1917CrossRefGoogle Scholar
  12. 12.
    Johansson K, Cnattingius S, Näslund I, Roos N, Trolle Lagerros Y, Granath F et al (2015) Outcomes of pregnancy after bariatric surgery. N Engl J Med 372(9):814–824CrossRefGoogle Scholar
  13. 13.
    Kjær MM, Lauenborg J, Breum BM, Nilas L (2013) The risk of adverse pregnancy outcome after bariatric surgery: a nationwide register-based matched cohort study. Obstet Gynecol. 208(6):464.e1, 464.e5Google Scholar
  14. 14.
    Kjær M, Nilas L (2013) Pregnancy after bariatric surgery—a review of benefits and risks. Acta Obstet Gynecol Scand 92(3):264–271CrossRefGoogle Scholar
  15. 15.
    Josefsson A, Blomberg M, Bladh M, Frederiksen SG, Sydsjö G (2011) Bariatric surgery in a national cohort of women: sociodemographics and obstetric outcomes. Obstet Gynecol. 205(3):206.e1, 206.e8Google Scholar
  16. 16.
    Sheiner E, Levy A, Silverberg D, Menes TS, Levy I, Katz M et al (2004) Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Obstet Gynecol 190(5):1335–1340Google Scholar
  17. 17.
    Abodeely A, Roye GD, Harrington DT, Cioffi WG (2008) Pregnancy outcomes after bariatric surgery: maternal, fetal, and infant implications. Surg Obes Relat Dis 4(3):464–471CrossRefGoogle Scholar
  18. 18.
    Sheiner E, Balaban E, Dreiher J, Levi I, Levy A (2009) Pregnancy outcome in patients following different types of bariatric surgeries. Obes Surg 19(9):1286–1292CrossRefGoogle Scholar
  19. 19.
    Dalfrà MG, Busetto L, Chilelli NC, Lapolla A. Pregnancy and foetal outcome after bariatric surgery: a review of recent studies. J Matern Fetal Neonat Med. 2012Google Scholar
  20. 20.
    Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M et al (2008) Pregnancy and fertility following bariatric surgery: a systematic review. JAMA 300(19):2286–2296CrossRefGoogle Scholar
  21. 21.
    Kessous R, Davidson E, Meirovitz M, Sergienko R, Sheiner E. Prepregnancy obesity: a risk factor for future development of ovarian and breast cancer. Eur J Cancer Prev. 2016Google Scholar
  22. 22.
    Sasson I, Beharier O, Sergienko R, Szaingurten-Solodkin I, Kessous R, Belfair NJ et al (2015) Obesity during pregnancy and long-term risk for ophthalmic morbidity—a population-based study with a follow-up of more than a decade. J Matern Fetal Neonat Med 2015:1–5CrossRefGoogle Scholar
  23. 23.
    Yaniv-Salem S, Shoham-Vardi I, Kessous R, Pariente G, Sergienko R, Sheiner E (2016) Obesity in pregnancy: what’s next? Long-term cardiovascular morbidity in a follow-up period of more than a decade. J Matern Fetal Neonat Med 29(4):619–623CrossRefGoogle Scholar
  24. 24.
    Willis K, Alexander C, Sheiner E (2016) Bariatric surgery and the pregnancy complicated by gestational diabetes. Curr Diabetes Rep 16(4):1–11CrossRefGoogle Scholar
  25. 25.
    Estampador AC, Franks PW (2014) Genetic and epigenetic catalysts in early-life programming of adult cardiometabolic disorders. Diabetes Metab Syndr Obes 1(7):575–586Google Scholar
  26. 26.
    Abokaf H, Shoham-Vardi I, Sergienko R, Landau D, Sheiner E (2018) In utero exposure to gestational diabetes mellitus and long term endocrine morbidity of the offspring. Diabetes Res Clin Pract 144:231–235CrossRefGoogle Scholar
  27. 27.
    Farahvar S, Walfisch A, Sheiner E (2019) Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review. Expert Rev Endocrinol Metab 14(1):63–74CrossRefGoogle Scholar
  28. 28.
    Levy DP, Sheiner E, Wainstock T, Sergienko R, Landau D, Walfisch A (2017) Evidence that children born at early term (37–38 6/7 weeks) are at increased risk for diabetes and obesity-related disorders. Obstet Gynecol. 217(5):588.e1, 588.e11Google Scholar
  29. 29.
    Knowler WC, Pettitt DJ, Saad MF, Bennett PH (1990) Diabetes mellitus in the Pima Indians: incidence, risk factors and pathogenesis. Diabetes Metab 6(1):1–27CrossRefGoogle Scholar
  30. 30.
    Gluckman PD, Hanson MA, Buklijas T, Low FM, Beedle AS (2009) Epigenetic mechanisms that underpin metabolic and cardiovascular diseases. Nat Rev Endocrinol 5(7):401–408CrossRefGoogle Scholar
  31. 31.
    Ma RC, Tutino GE, Lillycrop KA, Hanson MA, Tam WH (2015) Maternal diabetes, gestational diabetes and the role of epigenetics in their long term effects on offspring. Prog Biophys Mol Biol 118(1):55–68CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Soroka University Medical CenterBen-Gurion University of the NegevBeershebaIsrael
  2. 2.The Department of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeershebaIsrael
  3. 3.Department of Pediatrics, Soroka University Medical CenterBen-Gurion University of the NegevBeershebaIsrael

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