Abstract

IntroductionAccording to the fetal overnutrition hypothesis, obesity in pregnancy predisposes the offspring to obesity. Previous studies have suggested that after biliopancreatic surgery for obesity, the offspring is less likely to be obese. This study aims to further compare the BMI development of children born before and after maternal surgical weight loss.MethodWomen with at least one child born before and one child born after bariatric surgery were identified by record-linkage. Information about maternal BMI was extracted from medical records, as was information about the children's BMI from birth to 10 years of age. We retrieved BMI data at four years of age for 340 children, born to 223 women (164 children born before surgery (BS), 176 children born after surgery (AS)). We evaluated prevalence of overweight/obesity and mean BMI in children born BS and AS at the ages of four, six and ten using GEE regression models. For 71 families, where we had complete data on mother and both children, we used a fixed-effects regression model to explore the association between differences in maternal BMI in w10 of the pre- and post-operative pregnancies with siblings' BMI differences at age four.ResultsIn no age group did we see a significantly reduced prevalence of overweight/obesity AS. For 10-year-old girls, the AS group had significantly higher rates of obesity. There was no association between differences in maternal BMI in early pregnancy and differences in siblings' BMI at four years of age (β = −0.01, CI 95% = −0.11; 0.09).ConclusionsWe have been unable to demonstrate any effect of bariatric surgery on weight development in offspring. It seems unlikely that restrictive bariatric surgery conveys a protective effect in offspring with regards to obesity.

Highlights

  • According to the fetal overnutrition hypothesis, obesity in pregnancy predisposes the offspring to obesity

  • We have been unable to demonstrate any effect of bariatric surgery on weight development in offspring

  • It seems unlikely that restrictive bariatric surgery conveys a protective effect in offspring with regards to obesity

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Summary

Introduction

According to the fetal overnutrition hypothesis, obesity in pregnancy predisposes the offspring to obesity. A woman who is obese as she enters pregnancy is at risk of hyperinsulinemia, dyslipidemia and impaired endothelial function [3]. These conditions, combined with the up-regulation of inflammatory processes which occurs concurrently with them, all put the infant at risk of childhood obesity, and of developing type 2 diabetes, cardiovascular disease and obesity later in life [4,5]. The recommended gestational weight gain is 11– 20 lbs, or 5–9 kgs), had a strongly increased risk of delivering a LGA baby [7]

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