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Association of Maternal Roux-en-Y Gastric Bypass with Obstetric Outcomes and Fluid Intelligence in Offspring

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Abstract

Purpose

The purpose of the study is to assess whether Roux-en-Y gastric bypass (RYGB) prior to pregnancy is associated with fluid intelligence in offspring. Additionally, perinatal and obstetric outcomes, and children nutritional status were evaluated.

Material and Methods

Singleton births of women who underwent RYGB between 2000 and 2010 (BS) were matched to two control births by maternal age, delivery year, and gender. Control group 1 (CG1) and control group 2 (CG2) included women with a pre-pregnancy body mass index (BMI) < 35 kg/m2 and ≥ 35 kg/m2, respectively, who had never undergone bariatric surgery.

Results

Thirty-two children from each group (n = 96) were analyzed, mostly female (59%) and Caucasian (82%), with a mean age of 7 ± 2 years. Their general intelligence scores were similar after adjusting for sociodemographic confounders; family economic class was the strongest predictor (low: β = − 20.57; p < 0.001; middle: β = − 9.34; p = 0.019). Gestational diabetes mellitus (OR 0.06; 95% CI 0.03; 0.35) and hypertensive disorders (OR 0.09; 95% CI 0.01; 0.40) were less frequent in BS than CG2. Post-RYGB pregnancies were associated with lower birth weight (P = 0.021) than controls. Child overweight and obesity was higher (OR 4.59; 95% CI 1.55; 13.61; p = 0.006) in CG2 (78%) than CG1 (44%) and similar to BS (65%).

Conclusions

RYGB prior to pregnancy was not associated with fluid intelligence in offspring. Prior RYGB was associated with a lower frequency of gestational diabetes mellitus and hypertensive disorders than in women with a pre-pregnancy BMI ≥ 35 kg/m2, as well as with lower birth weight than both control groups.

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Abbreviations

BMI:

Body mass index

BW:

Birth weight

GA:

Gestational age

GDM:

Gestational diabetes mellitus

GEE:

Generalized estimating equation

GWG:

Gestational weight gain

HPD:

Hypertensive pregnancy disorders

IOM:

Institute of Medicine

LGA:

Large for gestational age

OR:

Odds ratio

RCPM:

Raven’s Colored Progressive Matrices

RPM:

Raven’s Progressive Matrices

RYGB:

Roux-en-Y gastric bypass

SD:

Standard deviation

SE:

Standard error

SGA:

Small for gestational age

WC:

Waist circumference

WHO:

World Health Organization

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Funding Sources

The study was funded by the Fundo de Incentivo à Pesquisa e Eventos (FIPE) of the Hospital de Clínicas de Porto Alegre and the National Council of Technological and Scientific Development (CNPq).

Author information

Authors and Affiliations

  1. Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, prédio 12, 4° andar, Porto Alegre, 90035-003, RS, Brazil

    Carina Andriatta Blume & Beatriz D. Schaan

  2. Faculty of Nutrition, UFRGS, Porto Alegre, RS, Brazil

    Brenda Moretto Machado

  3. Faculty of Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil

    Raíssa Ramos da Rosa & Maisa dos Santos Rigoni

  4. Center for Obesity and Metabolic Syndrome, Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil

    Daniela Schaan Casagrande & Cláudio Corá Mottin

  5. School of Medicine, PUCRS, Porto Alegre, Brazil

    Cláudio Corá Mottin

  6. Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Beatriz D. Schaan

Authors
  1. Carina Andriatta Blume
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  2. Brenda Moretto Machado
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  5. Daniela Schaan Casagrande
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  6. Cláudio Corá Mottin
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Correspondence to Carina Andriatta Blume.

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The authors declare that they have no conflicts of interest.

Ethical Approval

The study was performed according to the principles of the Helsinki Declaration. The HCPA and HSLPUCRS Ethics Committees approved the study protocol.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Blume, C.A., Machado, B.M., da Rosa, R.R. et al. Association of Maternal Roux-en-Y Gastric Bypass with Obstetric Outcomes and Fluid Intelligence in Offspring. OBES SURG 28, 3611–3620 (2018). https://doi.org/10.1007/s11695-018-3407-5

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  • DOI: https://doi.org/10.1007/s11695-018-3407-5

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