As reported in JAMA, researchers examined data on more than 33,000 women with a history of severe obesity who gave birth, including 2,921 who had gastric bypass surgery and lost weight before conception. Overall, 3.4% of women who had surgery had babies with major birth defects, compared with 4.9% of women who didn’t have weight-loss operations.
Changes in weight and blood sugar may explain these results, said lead study author Martin Neovius, from the Karolinska Institute in Stockholm.
“Both obesity and poorly controlled blood sugar are associated with increased risk of birth defects in a dose-dependent manner,” Neovius said by email. “This means that the more obese you are, the greater the risk of birth defects, and the worse blood glucose control, the greater the risk of birth defects.”
In the surgery group, women started out with an average body mass index (BMI) of 43.5 and an average weight of 122 kilograms (269 pounds). After surgery, their average body weight was 82 kilograms (181 pounds) prior to conception.
Before gastric bypass surgery, 9.7% of the women in that group had been taking prescription diabetes drugs to lower their blood sugar. But in the six months prior to conception, only 1.5% of them took diabetes drugs.
“These improvements may be the mechanism behind the observed lower risk of birth defects,” Neovius said.
Major heart defects accounted for 60% of the birth defects among mothers who underwent gastric bypass procedures. No babies in this group had neural tube defects, while there were 20 cases of neural tube defects among women who didn’t have surgery.
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