UKCO2019 Oral Communications (1) (1) (5 abstracts)
1Institute of Health and Society, Newcastle upon Tyne, UK; 2University Hospital Leuven, Leuven, Belgium.
Background: Small-for-gestational-age (SGA) is defined as a baby born <10th percentile for birth weight, age, and sex. Women with previous bariatric surgery have >2-fold risk of having a SGA baby, especially following malabsorptive surgery such as Roux-en-Y gastric bypass (RYGB). Babies born SGA are at an increased risk for morbidity and mortality; however, adverse outcomes are significantly improved when SGA identification occurs antenatally. This study aimed to investigate maternal risk factors for delivering an SGA baby after bariatric surgery.
Methods: This case-control study includes babies born from the AURORA (bAriatric sUrgery Registration in wOmen of Reproductive Age) cohort study. AURORA is a multi-centre prospective cohort study of women aged 1845 in Belgium. Women who already have had or will undergo bariatric surgery are followed until six months after a subsequent pregnancy. Maternal risk factors investigated included both modifiable factors and clinical indicators, such as gestational weight gain (GWG), type of surgery, and surgery-to-conception interval. Multiple logistic regression was carried out adjusting for maternal age at conception.
Results: We included 25 SGA babies and 97 appropriate-for-gestational-age (AGA between 10th90th percentiles) babies defined using birth weight, gestational age, sex, and parity. GWG was lower in SGA mothers (9.8 vs 13 kg) and was associated with decreased odds of SGA per kg of GWG (OR 0.92 95% CI 0.850.99). After grouping women according to Institute of Medicine GWG guidelines, nearly half of SGA mothers fell into the inadequate category (44% SGA vs 17% AGA) whereas more than half of AGA mothers fell into the excessive group (28% SGA vs 53% AGA). Pre-pregnancy BMI was lower in SGA mothers compared with AGA mothers (26 vs 29 kg/m2), and weight loss after surgery was higher (46 vs 39 kg). Fewer mothers had gestational diabetes in the SGA group (16% vs 25%).
Conclusions: Maternal GWG appears to be an important factor for SGA among women who have had bariatric surgery prior to pregnancy. Further research is required to explore appropriate GWG in this population.
Keywords: Bariatric surgery, pregnancy, fetal growth, GWG
Disclosures: This study was funded by a Newcastle University Research Excellence Academy PhD studentship.