800: Offspring of women following bariatric surgery are at an increased risk for long-term pediatric hematological morbidity

Abstract

To investigate whether offspring of women following bariatric surgery, as well as these suffering from obesity during their pregnancy, are at an increased risk for long-term pediatric hematological morbidity. A population based cohort study was performed comparing the risk of long-term hematological morbidity (up to the age of 18 years) of children of patients following bariatric surgery and obese women (as compared with non-obese parturients). Deliveries occurred between the years 1991-2013 in a tertiary medical center. Multiple pregnancies and fetal congenital malformations were excluded. Kaplan-Meier survival curves were constructed in order to compare cumulative hematological morbidity. Cox proportional hazards model was used to control for confounders. During the study period 253,808 newborns met the inclusion criteria; 961 were delivered to patients following bariatric surgery, 2473 were delivered to obese women and 250,374 were delivered to non-obese, non-post bariatric patients. Long-term total hematological morbidity was non-significantly higher in children delivered to patients following bariatric surgery (p=0.07, Table; Log rank p=0.07, Figure). Nevertheless, in a Cox proportional hazards model, controlling for important confounders such as maternal age, gestational age at birth, pregnant number, diabetes, hypertension, caesarian delivery, nation, smoking and low APGAR score at 5 minutes; Children delivered to women following bariatric surgery had higher rates of long term total hematological morbidity (adjusted HR=2.12, 95% CI 1.3-3.5; P<0.01). Using the same model, no association was noted between obesity and long term pediatric hematological morbidity (adjusted HR=0.89 95% CI 0.6-1.3; P=0.54). Specifically, bariatric surgery was independently associated with pediatric anemia (adjusted HR=2.02, 95% CI 1.1-3.8 P=0.03) and with thrombocytopenia (adjusted HR=2.6, 95% CI 1.2-5.9 P=0.02). Offspring of women following bariatric surgery are at an increased risk for long-term pediatric hematological morbidity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)