Gastric bypass surgery confers risk for growth restriction, mineral deficiencies in neonates
Infants born to mothers who underwent gastric bypass surgery are more likely to have mineral deficiencies than infants born to mothers who did not undergo the procedure, according to study findings presented at the annual meeting of the European Society for Paediatric Endocrinology in Paris.
“When a woman has gastric bypass, it’s important to have careful follow-up and a mineral supplementation,” Maxime Gerard, MD, of the department of pediatrics at Ambroise Paré University Hospital, Boulogne-Billancourt, France, told Endocrine Today. “During pregnancy, it’s essential to be followed monthly by a referential center in order to check fetal growth and nutritional status. Gastric bypass is a risk factor to have restriction of fetal growth and mineral deficiencies in neonates.”
Gerard and colleagues analyzed the clinical and cord blood biological characteristics from 56 newborns of mothers who underwent prior gastric bypass surgery, as well as 56 newborns of healthy mothers in the obstetrics department of Angers University Hospital between 2008 and March 2012. Women who underwent gastric bypass surgery took multivitamin and trace element supplements; blood was drawn at delivery for nutritional assessment.
Infants of mothers who underwent prior gastric bypass weighed a mean of 0.34 kg less than infants born to mothers who did not undergo gastric bypass (P < .01); 23% of infants born to gastric bypass mothers were small for gestational age vs. 3.6% in the control group (OR = 8.2; 95% CI, 1.7-38.1).
Infants born to gastric bypass mothers also had lower mean cord blood concentrations for calcium, zinc and vitamin A vs. infants born to mothers who did not undergo the surgery (P < .05); ORs for cord blood concentrations below the 2.5th percentile were significant in these infants for calcium (OR = 4.3; 95% CI, 1.3-14.1), zinc and iron (OR = 3·8; 95% CI, 1-14.8) and vitamin A (OR = 3.5; 95% CI, 1.1-11.8). In contrast, infants born to gastric bypass mothers were more likely to have cord blood concentrations greater than the 97.5th percentile for magnesium (OR = 4.3; 95% CI, 1.1-16.4) and vitamin E (OR = 4.6; 95% CI, 1.2-17.3), which researchers attributed to maternal supplementation.
Birth weight was related to variation in BMI between surgery and pregnancy (P < .01) and unrelated to time between surgery and pregnancy, BMI at pregnancy onset and weight gain during pregnancy. In addition, when compared with controls, mothers who underwent gastric bypass were more likely to have low concentrations ( 2.5th percentile) for calcium (13%), phosphorus (18%), zinc (21%), vitamin A (18%), and insulin-like growth factor I (28%; P < .05 for all).
“Our work shows for the first time that there are mineral deficiencies in neonates born from mothers who undergo gastric bypass,” Gerard said. “Growth and the nutritional status of neonates should be followed. It’s the object of future work.” – by Regina Schaffer
Gerard M, et al. Poster #P1-P546. Presented at: 55th Annual Meeting of the European Society for Paediatric Endocrinology; Sept. 10-12, 2016; Paris.
Disclosure: Gerard reports no relevant financial disclosures.