Pregnancy Nutritional Indices and Birth Weight After Roux-en-Y Gastric Bypass

Faintuch, Joel; Dias, Maria Carolina Gonçalves; Fazio, Eliener de Souza; Oliveira, Fernanda Castello Branco Mariz de; Nomura, Roseli Mieko Yamamoto; Zugaib, Marcelo; Cecconello, Ivan

doi:10.1007/s11695-008-9755-9

Cited by 40 publications

(26 citation statements)

References 21 publications

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“…In cases in which the studies performed both unadjusted linear correlations and adjusted regression coefficients we reported the latter (as B-or b-coefficients), but if only unadjusted correlations were carried out, we reported the former (as r coefficients). One study showed a significant positive correlation (17), and 9 showed no association between vitamin B-12 and BW [2 positive but nonsignificant (103, 108), 5 negative (24,29,61,87,105), and 2 showed varying associations at different time points (96,113)]. …”

Section: Effect Of Vitamin B-12 Concentrations Across the Spectrum On Bwmentioning

confidence: 99%

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Sukumar

Rafnsson

Kandala

et al. 2016

The American Journal of Clinical Nutrition

107

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Background: Vitamin B-12 and folate are micronutrients essential for normal embryogenesis. Vitamin B-12 insufficiency in pregnancy is high in certain parts of the world, such as India, and although this has been linked to low birth weight (LBW) in these populations, the relation between vitamin B-12 and birth weight (BW) elsewhere is unknown. Objectives: We performed a systematic review to assess 1) the worldwide prevalence of vitamin B-12 insufficiency in pregnancy and 2) its association with BW. Design: A search of 5 electronic databases was performed to identify eligible articles. Random-effects meta-analysis was conducted according to geographic regions and pregnancy trimesters for the prevalence subreview and by categorical measures of BW. Results: A total of 57 and 23 articles were included for the prevalence and BW subreviews, respectively. The pooled estimates of vitamin B-12 insufficiency were 21%, 19%, and 29% in the first, second, and third trimesters, respectively, with high rates for the Indian subcontinent and the Eastern Mediterranean. The large heterogeneity between studies was partially addressed by creating a standardized score for each study (mean vitamin B-12 insufficiency O cutoff value), which internally corrected for geographic region, trimester, and assay type. Twelve of the 13 longitudinal studies included showed a decrease in mean or median vitamin B-12 across trimesters. Pooled analysis showed nonsignificantly lower maternal vitamin B-12 concentrations in LBW than in normal-BW infants and higher odds of LBW with lower vitamin B-12 values (adjusted OR: 1.70; 95% CI: 1.16, 2.50), but studies from India largely contributed to the latter. Conclusions: Our review indicates that vitamin B-12 insufficiency during pregnancy is common even in nonvegetarian populations and that concentrations of vitamin B-12 decrease from the first to the third trimester. There is no consistent association between vitamin B-12 insufficiency and LBW. However, given the long-term risks of LBW, this observation warrants further cohort studies and randomized controlled trials.Am J Clin Nutr 2016;103:1232-51.

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Section: Effect Of Vitamin B-12 Concentrations Across the Spectrum On Bwmentioning

confidence: 99%

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Sukumar

Rafnsson

Kandala

et al. 2016

The American Journal of Clinical Nutrition

107

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“…[12][13][14][15] The monitoring of nutrient deficiencies after bariatric surgery, despite routine multivitamin supplementation, is important. [16][17][18] Guidelines suggest screening for micronutrient deficiencies annually beginning the year after bariatric surgery. 19,20 There are no prior investigations of laboratory testing for and diagnosis of micronutrient deficiency in women who become pregnant after bariatric surgery.…”

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confidence: 99%

Laboratory Testing for and Diagnosis of Nutritional Deficiencies in Pregnancy Before and After Bariatric Surgery

Gadgil

Chang

Richards

et al. 2014

Journal of Women's Health

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Objective: Bariatric surgery can reduce the risk of obesity-related complications of pregnancy, but may cause essential nutrient deficiencies. To assess adherence to laboratory testing guidelines, we examined frequency of testing for and diagnosis of deficiency during preconception and pregnancy using claims data in women with a delivery and bariatric surgery. Methods: Retrospective analysis of claims from seven Blue Cross Blue Shield plans between 2002 and 2008. We included women with a delivery and bariatric surgery within the study period. We used common procedural terminology (CPT) and ICD-9 codes to define laboratory testing and deficiencies for iron, folate, vitamin B12, vitamin D, and thiamine. Using Student's t-test and chi-square testing, we compared frequency of laboratory tests and diagnoses during 12 months preconception and 280 days of pregnancy between women with pregnancy before versus after surgery. We used multivariate logistic regression to evaluate for predictors of laboratory testing. Results: We identified 456 women with pregnancy after bariatric surgery and 338 before surgery. The frequency of testing for any deficiency was low (9%-51%), but higher in those with pregnancy after surgery ( p < 0.003). The most common deficiency was vitamin B12 (12%-13%) with pregnancy after surgery ( p < 0.006). Anemia and number of health provider visits were independent predictors of laboratory testing. Conclusion: Women with pregnancy after bariatric surgery were tested for and diagnosed with micronutrient deficiencies more frequently than those with pregnancy before surgery. However, most laboratory testing occurred in less than half the women and was triggered by anemia. Increased testing may help identify nutrient deficiencies and prevent consequences for maternal and child health.

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“…Based on a systematic review to identify literature related to micronutrient deficiencies occurring after bariatric surgery, Shankar and colleagues noted that bariatric surgery patients are at increased risk for deficiency of a number of nutrients following surgery (e.g., vitamin B 12 , folate, and iron) [17]. Consequently, the authors recommended prenatal supplementation for pregnant women who have undergone bariatric surgery due to reported associations between micronutrient deficiencies and maternal and fetal complications, including anemia and low birth weight [17,18]. Indeed, we found a statistically significant association between prior bariatric surgery and delivery of an infant that was SGA (regardless of maternal obesity status), even after controlling for maternal anemia status.…”

Section: Discussionmentioning

confidence: 99%

Impact of prior bariatric surgery on maternal and fetal outcomes among obese and non-obese mothers

Belogolovkin

Salihu

Weldeselasse

et al. 2011

Arch Gynecol Obstet

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Pregnancy Nutritional Indices and Birth Weight After Roux-en-Y Gastric Bypass

Cited by 40 publications

References 21 publications

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

Laboratory Testing for and Diagnosis of Nutritional Deficiencies in Pregnancy Before and After Bariatric Surgery

Impact of prior bariatric surgery on maternal and fetal outcomes among obese and non-obese mothers

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