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Neonatal Outcomes of Pregnancy Following Roux-en-Y Gastric Bypass: a Matched Case-Control Study

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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.

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Funding

This study was funded by Fundo de Incentivo à Pesquisa e Eventos (FIPE) of Hospital de Clínicas de Porto Alegre and by National Council for Scientific and Technological Development (CNPq). 

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Authors and Affiliations

  1. Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Brenda M. Machado

  2. Postgraduate Program in Medical Sciences, Endocrinology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Carina A. Blume & Beatriz D. Schaan

  3. Center for Obesity and Metabolic Syndrome, Hospital São Lucas da Pontifícia, Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    Cláudio C. Mottin

  4. School of Medicine, PUCRS, Porto Alegre, RS, Brazil

    Cláudio C. Mottin

  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

    Michele Drehmer

  6. Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Prédio 12 - 4° andar, Porto Alegre, 90035-003, RS, Brazil

    Beatriz D. Schaan

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  1. Brenda M. Machado
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  2. Carina A. Blume
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Correspondence to Beatriz D. Schaan.

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The authors declare that they have no conflicts of interest.

Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Machado, B.M., Blume, C.A., Mottin, C.C. et al. Neonatal Outcomes of Pregnancy Following Roux-en-Y Gastric Bypass: a Matched Case-Control Study. OBES SURG 30, 2963–2970 (2020). https://doi.org/10.1007/s11695-020-04633-x

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  • DOI: https://doi.org/10.1007/s11695-020-04633-x

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