title: Micronutrient levels and supplement intake in pregnancy after bariatric surgery: a prospective cohort study.
abstract: BACKGROUND
  Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery.
  
  
  OBJECTIVE
  To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery.
  
  
  METHODS
  A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy.
  
  
  RESULTS
  The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies.
  
  
  CONCLUSIONS
  Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Guelinckx
authors.affiliation: Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Goele
authors.initials: G
authors.lastname: Jans
authors.affiliation: Jessa Hospital, 3500 Hasselt, Belgium.
authors.forename: Willy
authors.initials: W
authors.lastname: Voets
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Hospital Oost-Limburg (ZOL), 3600 Genk, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vanholsbeke
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
authors.forename: Greet
authors.initials: G
authors.lastname: Vansant
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D050110:Bariatric Surgery / Q000009:adverse effects*; D002762:Cholecalciferol / Q000097:blood; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000032:analysis; D006801:Humans; D018977:Micronutrients / Q000008:administration & dosage / Q000172:deficiency*; D009765:Obesity / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D014801:Vitamin A / Q000097:blood; D014805:Vitamin B 12 / Q000032:analysis; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D014815:Vitamins / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D018977:Micronutrients; D014815:Vitamins; D014801:Vitamin A; D002762:Cholecalciferol; D005492:Folic Acid; D014805:Vitamin B 12