ESPE Abstracts (2016) 86 P-P1-546

Higher Risk of Low Birth Weight and Multiple Nutritional Deficiencies in Neonates from Mothers after Gastric Bypass: A Case Control Study

Maxime Gerarda,b, Geraldine Gascoinb, Agnes Salled, Dorothee Freind, Philippe Toparte, Guillaume Becouarne, Francoise Schmittc, Claire Brietd, Stephanie Rouleaub, Loic Sentilhesf & Regis Coutantb

aDepartment of Pediatrics, Ambroise Pare University Hospital, Boulogne Billancourt, France; bDepartment of Pediatrics, ANGERS University Hospital, ANGERS, France; cDepartment of Pediatric Surgery, ANGERS University Hospital, ANGERS, France; dDepartment of Endocrinology, Diabetology, and Nutrition, ANGERS University Hospital, ANGERS, France; eDepartment of Surgery, Anjou Clinical Center, ANGERS, France; fDepartment of Gynecology and Obstretrics, ANGERS University Hospital, ANGERS, France

Background: Maternal bariatric surgery is associated with increased risk of small-for-gestational-age infants. Risk of nutritional deficiencies in neonates of mothers with prior gastric bypass (GBP) is unclear.

Methods: This study compared the clinical and cord blood biological characteristics of 56 newborns of GBP mothers and 56 newborns of healthy mothers, in the Obstetrics Department of Angers University Hospital between 01/03/2008 and 31/10/2012. After GBP, the women took multivitamin and trace element supplements. They had blood drawn at delivery for nutritional assessment.

Results: GBP mothers lost 18.1±6.3 kg/m2 of BMI in the 11–69 months between surgery and pregnancy onset, reaching BMI of 30.1±6.0 kg/m2 compared with 22.3±4.0 kg/m2 in the controls (P<0.05). Birth weight was 0.34 kg lower in neonates born to GBP mothers (P<0.01), and 23% were small for gestational age vs. 3.6% in control group (odds ratio 8.2, 95% CI 1.7–38.1, P<0.01). Cord blood mean concentrations were significantly lower for Ca, zinc, and vitamin A (P<0.05). OR for cord blood concentrations below the 2.5th percentile were significant in GBP neonates for calcium [4.3 (1.3;14.1)], zinc and iron [3.8 (1.0; 14.8)], and vitamin A [OR 3.5 (1.1;11.8)]. In contrast, the OR for cord blood concentrations over the 97.5th percentile were significant in GBP neonates for Mg [OR 4.3 (1.1;16.4)] and vitamin E [OR 4.6 (1.2;17.3)], owing to maternal supplementation. Birth weight was related to variation in BMI between surgery and pregnancy (r=0.45, P<0.01) and unrelated to time between surgery and pregnancy, BMI at pregnancy onset, and weight gain during pregnancy. A significantly higher percentage of GBP mothers than expected displayed concentrations <2.5th percentile for calcium (13%), phosphorus (18%), zinc (21%), vitamin A (18%), and IGF-1 (28%) (P<0.05).

Conclusion: Neonates from GBP mothers showed nutritional deficiencies. The long-term consequences remain to be explored.