Neonatal Outcomes and the Risk of Congenital Anomalies After Maternal Bariatric Surgery.

INTRODUCTION

Maternal history of bariatric surgery (MHBS) has been previously linked to higher rates of congenital anomalies and poor neonatal outcomes. However, limited data exist on the impact of bariatric procedure type and timing from MHBS to conception.

METHODS

A retrospective cohort study evaluated infants born between January 1, 2012, and December 31, 2022 to mothers with a history of prior bariatric surgery. Rates of congenital anomalies and neonatal outcomes were compared by bariatric procedure type (restrictive versus malabsorptive) and timing from surgery to conception (≤1 y versus >1 y) using Chi-Square, Fisher's Exact, and Mann-Whitney U tests; significance P < 0.05.

RESULTS

One hundred thirty infants were born to patients with an MHBS. Restrictive bariatric procedures included gastric banding (28.7%) and sleeve gastrectomy (32.0%), and malabsorptive procedures included Roux-en-Y gastric bypass (39.3%). Maternal patients who previously underwent a malabsorptive procedure were more likely to be anemic (54.9% versus 29.1%, P = 0.003), have a nutritional deficiency during pregnancy (31.4% versus 15.2%, P = 0.028), or deliver an infant with low birth weight (27.5% versus 8.9%, P = 0.005). Infants conceived ≤1 y from surgery exhibited higher rates of fetal growth restriction (27.3% versus 2.5%, P < 0.001) and congenital anomalies (54.5% versus 22.7%, P = 0.02).

CONCLUSIONS

Mothers who underwent a malabsorptive bariatric procedure experienced higher rates of anemia, nutritional deficiency, and infants with low birth weight, but no difference in congenital anomalies compared to the restrictive cohort. Infants conceived ≤1 y from surgery experienced higher rates of congenital anomalies. These findings suggest the importance of close nutritional monitoring and obstetric counseling in the first year following bariatric surgery.