Weight Loss Surgery Before Pregnancy Improves Kid's Health

Biliopancreatic diversion
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Obese women who undergo weight loss surgery before pregnancy tend to have children who are less likely to become obese and to have risk factors for heart and metabolic conditions, such as high cholesterol and insulin resistance.

The study confirmed previous research in which investigators found that the intrauterine environment has a significant impact on whether a child will become obese when the mother is obese. The effect appears to be greater than the influence of genes and the post-natal environment. Thus obese women who choose to undergo weight-loss surgery before becoming pregnant have an opportunity to improve the health of their children by avoiding obesity and the health complications that typically accompany it.

In the study, researchers evaluated 49 women who had undergone biliopancreatic diversion (BPD) and who had had children both before and after their weight-loss procedure. The investigators found that the children born after their mothers had weight loss surgery had lower birth weight and waist circumference and were three times less likely to become severely obese. The post-surgery children also had improved cardiovascular markers, such as lower cholesterol levels and reduced insulin resistance. This is believed to be the first study to show that dramatic weight loss by pregnant women can have a positive impact on metabolic characteristics in their children.

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The type of weight loss surgery evaluated in the current study was biliopancreatic diversion, in which the stomach is made smaller. This allows people to feel full much more quickly, reducing the amount of food consumed, and causing the food to bypass part of the small intestine, resulting in absorption of fewer calories.

Typically, BPD and other weight loss surgeries (e.g., laparoscopic adjustable gastric banding, vertical banded gastroplasty, extended roux-en-y gastric bypass) are considered for people who have not been able to lose weight with other methods, who are at high risk for developing other health problems because of their weight, or who have a dangerous condition related to their weight, such as cardiovascular disease, gallbladder disease, or diabetes.

According to the study’s authors, obese women who want to have children should lose weight before becoming pregnant. If significant weight loss is not attainable, some women may want to consider weight-loss surgery prior to becoming pregnant. Being obese while pregnant not only increases the chances that the child will be obese and have associated complications, it also places the pregnant woman at risk for complications during pregnancy, including maternal high blood pressure and a greater chance of birth defects.

SOURCES:
Blomberg MI, Kallen B. Birth Defects Research. Part A. Clianical and Molecular Teratology 2009 Aug 26
Hincz P et al. Ginekologia polska 2q009 May; 80(5): 334-37
Science Daily, Sept. 1, 2009

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