title: Fetal growth in pregnancies conceived after gastric bypass surgery in relation to surgery-to-conception interval: a Danish national cohort study.
abstract: OBJECTIVE
  To describe early and late fetal growth in pregnancies conceived after gastric bypass surgery in relation to time from surgery to conception of pregnancy.
  
  
  METHODS
  National cohort study on 387 Danish women, who had laparoscopic or open gastric bypass surgery prior to a singleton pregnancy in which first trimester screening was performed between January 2008 and June 2011. Data were derived from national registers (Danish National Registry of Patients and Danish National Birth Registry, Pregnancy Complications and Abortion-clinical quality database (PreCAb) and the Danish Fetal Medicine Database). Main outcome measures were early and late fetal growth in relation to time from bariatric surgery to conception of the pregnancy. Early fetal growth was expressed as "Fetal Growth Index": the ratio between the estimated number of days from first trimester ultrasound to second trimester ultrasound biometries and the actual calender time elapsed in days. Late fetal growth was expressed as the observed versus expected birthweight according to gestational age (GA).
  
  
  RESULTS
  The surgery-to-conception interval ranged from 3 to 1851 days with a mean value of 502 (SD, 351) days. The mean "fetal growth index" was 0.99 (SD, 0.02) days/day and thus significantly lower than in the background population (mean, 1.04 (SD, 0.09) days/day, p<0.0001). The proportion of infants being small for gestational age was 18.8% and the proportion of large for gestational age infants was 6.7%. The correlation coefficients between surgery-to-conception time and "fetal growth index" and birthweight according to GA were 0.01 (p = 0.8) and 0.04 (p = 0.4), respectively.
  
  
  CONCLUSIONS
  Fetal growth index was lower than reported in the background population. No correlation was found between the surgery-to-conception interval and early or late fetal growth in pregnancies conceived after gastric bypass surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Hillerød Hospital, Copenhagen University Hospital, Hillerød, Denmark.
authors.forename: Lone Nikoline
authors.initials: LN
authors.lastname: Nørgaard
authors.affiliation: Department of Obstetrics and Gynecology, Hillerød Hospital, Copenhagen University Hospital, Hillerød, Denmark.
authors.forename: Anne Cathrine Roslev
authors.initials: AC
authors.lastname: Gjerris
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Ida
authors.initials: I
authors.lastname: Kirkegaard
authors.affiliation: Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Janne Foss
authors.initials: JF
authors.lastname: Berlac
authors.affiliation: Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ann
authors.initials: A
authors.lastname: Tabor
mesh_terms: D000328:Adult; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D047109:Fetal Development; D015390:Gastric Bypass / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D013997:Time Factors