OP13.09: Birthweight and intrauterine growth patterns of fetuses of pregnant women post‐bariatric surgery

Abstract

On this limited data, either mechanical or chemical IOL in suspected IUGR/SGA is reasonable. However, a sizeable RCT specifically to answer the question of chemical versus mechanical IOL in this group, ± pooling of SGA subgroup data from general IOL trials, is required to provide definitive data. Objectives: To characterise lipid metabolomic changes in maternal and umbilical cord blood of pregnancies with sub-optimal fetal growth. Methods: Prospective cohort study in singleton term gestations including 27 normally grown newborns and 51 small fetuses classified into small for gestational age (SGA) (if birthweight 3rd-9th and had normal fetoplacental Doppler. n=27) and fetal growth restriction (FGR) (if birthweight <3rd centile and/or abnormal fetoplacental Doppler; n=24). Maternal and cord blood samples were analysed by 1 H-NMR and diffusion data assessed by targeted metabolomics to determine lipoprotein content, choline and glycoprotein compounds (Liposcale ® test). Results: Targeted lipidomics could clearly discriminate between the groups. Lipoprotein profiles showed significantly lower maternal concentrations of cholesterol-IDL (-17%), and triglycerides-IDL as well as -HDL in small fetuses (both, SGA and FGR) compared to controls (all p<0.05). While FGR fetuses had significant higher levels of cholesterol-VLDL (+56%). -IDL (+24%). triglycerides-VLDL (+24%) and -IDL (+18%) than controls (all p<0.005) (Figure). Changes in phosphatidylcholines and glycoproteins were more prominent in FGR vs. controls, indicating significant alterations in their abundance and biophysical properties. Conclusions: These results provide a substantial understanding of the widespread disruption of lipid profiles in both maternal and cord blood of pregnancies with suboptimal fetal growth.

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

“…Several studies show that bariatric surgery combined with lifestyle modifications leads not only to reduced cardiovascular morbidity, diabetes, cancer, and overall mortality but also to improved fertility (see Fertility subsection above). While pregnancy is a contraindication for bariatric surgery, research indicates improved pregnancy outcomes in the follow-up period and after the recommended latency period (see below) [50,[59][60][61][62][63]. On the other hand, it has been proven that pregnant patients undergoing bariatric surgery are at higher risk for venous thromboembolisms, blood transfusion, induced labor, fetal growth restriction, and are at a significantly increased risk of needing further surgical procedures [59,[63][64][65][66].…”