Risk for congenital malformations in offspring of women who have undergone bariatric surgery. A national cohort

Authors

  • A Josefsson,

    Corresponding author
    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
    • Correspondence: Dr A Josefsson, Division of Obstetrics and Gynaecology, Department of Experimental and Clinical Medicine, Faculty of Health Sciences, Linköping University, SE—581 85 Linköping, Sweden. Email ann.josefsson@lio.se

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  • M Bladh,

    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
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  • A-B Wiréhn,

    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
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  • G Sydsjö

    1. Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden
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  • The copyright line for this article was changed on 29 October 2015 after original online publication.

Abstract

Objective

To study the risk for congenital anomalies in the first child of women after bariatric surgery compared with all other women giving birth to their first child and divided by maternal body mass index (BMI) groups.

Design

Prospective, population-based register study.

Setting

Sweden.

Sample

All firstborn children to women born 1973–83 were studied to determine if they had a congenital anomaly and a mother who had undergone bariatric surgery before pregnancy.

Methods

A total of 270 805 firstborns; of which 341 had mothers who had had bariatric surgery before delivery. We retrieved information on the women's marital or cohabitation status, smoking, BMI, diabetes and hypertension during pregnancy.

Main outcome measures

Congenital malformations.

Results

Of the firstborn children to mothers who had had bariatric surgery before pregnancy, 4.1% (95% confidence interval [95% CI] 2.2–6.0) were malformed compared with 3.4% (95% CI 3.3–3.5) of those whose mothers had not undergone bariatric surgery. The risk for congenital malformation in firstborn children increased with increasing maternal BMI. The adjusted odds ratio (OR) for congenital malformation among children whose mothers' BMI ranged between 25 and 29 kg/m2 was 1.09 (95% CI 1.03–1.15), whose mothers' BMI ranged between 30 and 34 kg/m2 was 1.14 (1.05–1.24) and whose mothers' BMI was ≥35 kg/m2 was 1.30 (95% CI 1.16–1.45) compared with those whose mothers had a normal BMI. Bariatric surgery before pregnancy did not have any effect on the odds ratio for having congenital malformation (OR = 1.09, 95% CI 0.63–1.91).

Conclusions

Preconception bariatric surgery does not seem to affect the risk for congenital malformations but a high to very high BMI does appear to increase the risk.

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