Is gastric bypass surgery a risk factor for foetal abnormalities?

  • JAMA

  • International Clinical Digest
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Takeaway

  • Women with Roux-en-Y gastric bypass surgery had fewer infants with birth defects.

Why this matters

  • Obesity is related to poor glucose control, which is teratogenic.

Key results

  • There were fewer birth defects in women with Roux-en-Y gastric bypass surgery compared with matched controls (3.4% vs 4.9%; risk ratio, 0.67; 95% CI, 0.52-0.87).
  • Mean weight loss in the surgery group was 40 kg; diabetes drug use decreased from 9.7% before surgery to 1.5% during the 6 months prior to conception.

Study design

  • Retrospective matched cohort study comparing women and infants with and without Roux-en-Y gastric bypass surgery.
  • Cohort obtained from a Swedish Medical Birth Register and from the Scandinavian Obesity Surgery Register from the same period.
  • Controls were matched by maternal presurgery BMI, diabetes, history of birth defects, delivery year, and a propensity score based on maternal age, alcohol and substance abuse, smoking, parity, and number of prescription drugs.
  • Funding: National Institute of Diabetes and Digestive and Kidney Diseases, NIH, the Swedish Research Council, and the Swedish Research Council for Health, Working Life, and Welfare. 

Limitations

  • Pregnancy terminations and stillbirths were not included.