Roux-en-Y Gastric Bypass Aggravates Vitamin A Deficiency in the Mother-Child Group

Obes Surg. 2018 Jan;28(1):114-121. doi: 10.1007/s11695-017-2791-6.

Abstract

Objective: The objectives of this study are to compare the nutritional status of vitamin A in women who previously underwent Roux-en-Y gastric bypass (RYGB) who became pregnant or did not, in the same period after surgery, and to assess its effects on mother and child health.

Methodology: A retrospective longitudinal study conducted with women who previously underwent RYGB, paired by age and BMI measured before surgery, divided into group 1 (G1) comprising 77 women who did not become pregnant and group 2 (G2) with 39 women in their third gestational trimester. Both groups were assessed before surgery (T0) and in the same interval after surgery: less than or equal to 1 year (T1) or over 1 year (T2), during a maximum of 2 years. Serum concentrations of retinol and β-carotene, night blindness (NB), and gestational and neonatal complications were investigated [urinary tract infection, iron deficiency anemia, hypertensive syndrome of pregnancy, dumping syndrome, birth weight, gestational age at birth (GAB), and correlation between weight and GAB]. Data were analyzed by the Statistical Package for Social Sciences 21.0 (p < 0.05).

Results: RYGB reduced the serum levels of retinol and β-carotene, especially before the first postsurgical year. When associated with pregnancy, inadequacy rate was 55% higher in T1 and T2. Comparing G1 to G2, we noted that pregnancy in women undergoing RYGB can contribute to increased inadequacy of retinol and β-carotene, reaching a higher percentage of women with NB after 1 postsurgical year. High prevalence of pregnancy/neonatal complications was found in T1 and T2. NB was correlated with inadequacy of β-carotene.

Conclusion: Pregnancy after RYGB aggravates vitamin A deficiency, increases the percentage of NB cases, and can contribute to pregnancy and neonatal complications even in 1 postsurgical year.

Keywords: Obstetric and neonatal outcomes; Pregnancy; Pregnancy complications; Roux-en-Y gastric bypass; Vitamin A.

MeSH terms

  • Adult
  • Birth Weight
  • Child
  • Disease Progression
  • Female
  • Gastric Bypass / adverse effects*
  • Humans
  • Infant, Newborn
  • Longitudinal Studies
  • Mother-Child Relations
  • Mothers
  • Nutritional Status
  • Obesity, Morbid / blood
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery*
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / etiology
  • Pregnancy Complications / surgery
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Vitamin A / blood*
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / etiology*
  • Vitamin A Deficiency / pathology*
  • Young Adult
  • beta Carotene / blood

Substances

  • beta Carotene
  • Vitamin A