title: Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery.
abstract: BACKGROUND
  Interaction between maternal obesity, intrauterine environment and adverse clinical outcomes of newborns has been described.
  
  
  METHODS
  Using statewide birth certificate data, this retrospective, matched-control cohort study compared paired birth weights and complications of infants born to women before and after Roux-en-Y gastric bypass surgery (RYGB) and to matched obese non-operated women in several different groups. Women who had given birth to a child before and after RYGB (group 1; n=295 matches) and women with pregnancies after RYGB (group 2; n=764 matches) were matched to non-operated women based on age, body mass index (BMI) prior to both pregnancy and RYGB, mother's race, year of mother/s birth, date of infant births and birth order. In addition, birth weights of 13 143 live births before and/or after RYGB of their mothers (n=5819) were compared (group 3).
  
  
  RESULTS
  Odds ratios (ORs) for having a large-for-gestational-age (LGA) neonate were significantly less after RYGB than for non-surgical mothers: ORs for groups 1 and 2 were 0.19 (0.08-0.38) and 0.33 (0.21-0.51), respectively. In contrast, ORs in all three groups for risk of having a small for gestational age (SGA) neonate were greater for RYGB mothers compared to non-surgical mothers (ORs were 2.16 (1.00-5.04); 2.16 (1.43-3.32); and 2.25 (1.89-2.69), respectively). Neonatal complications were not different for group 1 RYGB and non-surgical women for the first pregnancy following RYGB. Pregnancy-induced hypertension and gestational diabetes were significantly lower for the first pregnancy of mothers following RYGB compared to matched pregnancies of non-surgical mothers.
  
  
  CONCLUSIONS
  Women who had undergone RYGB not only had lower risk for having an LGA neonate compared to BMI-matched mothers, but also had significantly higher risk for delivering an SGA neonate following RYGB. RYGB women were less likely than non-operated women to have pregnancy-related hypertension and diabetes.
authors: Division of Cardiovascular Genetics, University of Utah and LiVe Well Center Salt Lake, Intermountain Healthcare, Salt Lake City, UT, USA.
authors: T D
authors: TD
authors: Adams
authors: 1] VF Michigan, Bloomfield Hills, MI, USA [2] Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.
authors: A O
authors: AO
authors: Hammoud
authors: 1] Department of Exercise Science, Brigham Young University, Provo, UT, USA [2] Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA.
authors: L E
authors: LE
authors: Davidson
authors: St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons and New York Obesity Nutrition Research Center, Division of Endocrinology, Diabetes and Nutrition, New York, NY, USA.
authors: B
authors: B
authors: Laferrère
authors: Department of Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
authors: A
authors: A
authors: Fraser
authors: Division of Public Health, University of Utah, Salt Lake City, UT, USA.
authors: J B
authors: JB
authors: Stanford
authors: Division of Public Health, University of Utah, Salt Lake City, UT, USA.
authors: M
authors: M
authors: Hashibe
authors: Division of Public Health, University of Utah, Salt Lake City, UT, USA.
authors: J L J
authors: JL
authors: Greenwood
authors: Division of Public Health, University of Utah, Salt Lake City, UT, USA.
authors: J
authors: J
authors: Kim
authors: Homer Warner Center for Informatics Research, Intermountain Healthcare, Salt Lake City, UT, USA.
authors: D
authors: D
authors: Taylor
authors: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA.
authors: A J
authors: AJ
authors: Watson
authors: Department of Population Sciences, Huntsman Cancer Institute and Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA.
authors: K R
authors: KR
authors: Smith
authors: Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.
authors: R
authors: R
authors: McKinlay
authors: Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.
authors: S C
authors: SC
authors: Simper
authors: Rocky Mountain Associated Physicians, Inc., Salt Lake City, UT, USA.
authors: S C
authors: SC
authors: Smith
authors: Division of Cardiovascular Genetics, University of Utah, Salt Lake City, UT, USA.
authors: S C
authors: SC
authors: Hunt
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D009767:Obesity, Morbid / Q000453:epidemiology / Q000378:metabolism / Q000601:surgery*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
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