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

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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References

  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):766–781

    Article  Google Scholar 

  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):804–814

    Article  Google Scholar 

  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):714–726

    Article  Google Scholar 

  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):1175–1182

    Article  CAS  Google Scholar 

  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:c3428

    Article  Google Scholar 

  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):147–152

    Article  CAS  Google Scholar 

  7. Ehrenberg HM, Mercer BM, Catalano PM (2004) The influence of obesity and diabetes on the prevalence of macrosomia. Obstet Gynecol 191(3):964–968

    CAS  Google Scholar 

  8. Gilead R, Yaniv Salem S, Sergienko R, Sheiner E (2012) Maternal, “isolated” obesity and obstetric complications. J Matern Fetal Neonat Med 25(12):2579–2582

    Article  Google Scholar 

  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):1724–1737

    Article  CAS  Google Scholar 

  10. Karmon A, Sheiner E (2008) Pregnancy after bariatric surgery: a comprehensive review. Arch Gynecol Obstet 277(5):381–388

    Article  Google Scholar 

  11. Santry HP, Gillen DL, Lauderdale DS (2005) Trends in bariatric surgical procedures. JAMA 294(15):1909–1917

    Article  CAS  Google Scholar 

  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):814–824

    Article  CAS  Google Scholar 

  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.e5

    Google Scholar 

  14. Kjær M, Nilas L (2013) Pregnancy after bariatric surgery—a review of benefits and risks. Acta Obstet Gynecol Scand 92(3):264–271

    Article  Google Scholar 

  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.e8

    Google Scholar 

  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):1335–1340

    Google Scholar 

  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):464–471

    Article  Google Scholar 

  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):1286–1292

    Article  Google Scholar 

  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. 2012

  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):2286–2296

    Article  CAS  Google Scholar 

  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. 2016

  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 2015:1–5

    Article  Google Scholar 

  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):619–623

    Article  CAS  Google Scholar 

  24. Willis K, Alexander C, Sheiner E (2016) Bariatric surgery and the pregnancy complicated by gestational diabetes. Curr Diabetes Rep 16(4):1–11

    Article  Google Scholar 

  25. Estampador AC, Franks PW (2014) Genetic and epigenetic catalysts in early-life programming of adult cardiometabolic disorders. Diabetes Metab Syndr Obes 1(7):575–586

    Google Scholar 

  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 144:231–235

    Article  CAS  Google Scholar 

  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):63–74

    Article  CAS  Google Scholar 

  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.e11

    Google Scholar 

  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):1–27

    Article  CAS  Google Scholar 

  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):401–408

    Article  CAS  Google Scholar 

  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):55–68

    Article  CAS  Google Scholar 

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Correspondence to Pinhas Damti.

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Damti, P., Friger, M., Landau, D. et al. Offspring of women following bariatric surgery and those of patients with obesity are at an increased risk for long-term pediatric endocrine morbidity. Arch Gynecol Obstet 300, 1253–1259 (2019). https://doi.org/10.1007/s00404-019-05322-6

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  • DOI: https://doi.org/10.1007/s00404-019-05322-6

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