Purpose Bariatric surgery (BS) increases the risk of small for gestational age (SGA) neonates. Guidelines recommend postponing pregnancy for 12–24 months, but optimal surgery-to-conception interval (BSCI) remains uncertain. We aimed to evaluate the impact of BSCI on birth weight and SGA. Materials and Methods Retrospective cohort study of 42 pregnancies following BS, including Roux-en-Y gastric bypass, gastric sleeve, adjustable gastric banding and biliopancreatic diversion. Neonates were classified as SGA if birth weight < 10th percentile. Optimal BSCI was obtained from the analysis of ROC curves, and pregnancies were compared by that cut-off. Results There was a linear association between BSCI and birth weight and an inverse association with SGA, with each additional month of BSCI translating into additional 4.5 g (95%CI: 2.0–7.0) on birth weight and -6% risk of SGA (95%CI: 0.90–0.99). We established a cut-off of 24.5 months of BSCI for lower risk of SGA. Pregnancies conceived in the first 24 months had a more than tenfold increased risk of SGA (OR 12.6, 95%CI: 2.4–66.0), even when adjusted for maternal age, gestational diabetes and inadequate gestational weight gain. Conclusion BSCI was associated with birth weight and SGA. Our results are in line with the recommendations of BSCI of at least 24 months to reduce the risk of SGA. Graphical Abstract

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Introduction: Adrenocortical carcinoma (AAC) is a rare and aggressive disease, associated with a poor prognosis. Surgery with complete resection (R0) remains the only curative treatment. However, even after complete resection, most patients present with distant metastatic disease. The aim of this study is to determine clinical and pathological features of metastatic disease in AAC. Materials and methods: Retrospective cohort study in 34 patients with AAC followed in our centre since 1991 until 2019. Selected patients with metastatic disease (n=21) and without metastatic disease (=13). Descriptive and comparative data analyses. Statistics: SPSS®v.23, with the variables: age, sex, clinical signs and symptoms, hormonal activity, imaging and pathological characteristics, surgical procedure, postoperative adjuvant treatments and overall survival. Results: 27 (79%) female and 7 (21%) male patients were included in our study, with a median age of 50 ± 13 years at the time of diagnosis. 21 patients (61,2%) presented with metastatic disease (38% of witch at the time of diagnosis) representing the metastatic disease group. 13 (38,8%) patients had no metastases until the collected data (group without metastatic disease). In the comparative analyses between the two groups, patients with metastatic disease had significantly more laparotomy procedures (71,2% n=15 vs 15,4% n=2; p&lt;0,05), bigger tumours (≥ 12cm) (52,4% n=11 vs 23% n=3; p&lt;0,05) and higher Ki67 (34,18% vs 1%, p&lt;0,05). Postoperatively, the metastatic group had higher LDH (LDH at 6 months) (582 ± 502 vs 181 ± 47; p&lt;0,05) and lower overall survival (months) (22,9 ± 4,69 vs 237,16 ± 44,42; p&lt;0,05). Patients with metastatic disease had more constitutional symptoms (weight loss and asthenia) (33,3% n = 7 vs 15,4% n = 2; p = 0.092) and incomplete surgical recessions (R1/R2) (42,8% n = 9 vs 15,4% n = 2; p=0.18), however, without statistical significance. There were no differences regarding: age, sex, hormonal activity, imaging characteristics and post-surgical medical treatment. Conclusion: In this study, the adrenocortical carcinoma metastasis rate was 61,2% with an overall survival of 23 months in the metastatic group. Laparotomy surgeries, tumour size ≥12cm and higher KI67 are features significantly associated with metastatic disease in adrenocortical carcinoma. Constitutional symptoms and incomplete surgical recessions are more common in metastatic patients, however without statistical significance, in this cohort. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.