Impact of maternal bariatric surgery on offspring perinatal cardiac function: A prospective study

Olga Patey; Margarita Bartsota; Tanya Maric; Deesha Patel; Makrina Savvidou; Julene S Carvalho

doi:10.1111/1471-0528.17747

Impact of maternal bariatric surgery on offspring perinatal cardiac function: A prospective study

BJOG. 2023 Dec 28. doi: 10.1111/1471-0528.17747. Online ahead of print.

Authors

Olga Patey¹, Margarita Bartsota¹, Tanya Maric^{2

3}, Deesha Patel^{2

3}, Makrina Savvidou^{2

3

4}, Julene S Carvalho^{1

5}

Affiliations

¹ Brompton Centre for Fetal Cardiology, Royal Brompton Hospital NHS Foundation Trust, London, UK.
² Academic Department of Obstetrics and Gynaecology, Chelsea & Westminster Hospital, London, UK.
³ Department of Metabolism, Digestion and Reproduction, Imperial College, London, UK.
⁴ Fetal Medicine Unit, Chelsea & Westminster Hospital, London, UK.
⁵ Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.

PMID: 38155109
DOI: 10.1111/1471-0528.17747

Abstract

Objective: To assess perinatal cardiac function in offspring of women with previous bariatric surgery and examine its association with maternal glucose control.

Design: Prospective study.

Setting: Maternity unit, UK.

Population: Fifty-four fetuses/neonates; 29 of post-bariatric surgery women and 25 of women without surgery.

Methods: Prospective, longitudinal observational study of pregnant women with and without previous bariatric surgery, matched for early pregnancy body mass index. Cardiac function of all offspring was assessed by two-dimensional conventional, spectral tissue Doppler and speckle-tracking echocardiography at 35-37 weeks of gestation and at 5-7 weeks of age. Maternal glycated haemoglobin (HbA1c) was measured at 27-30 weeks of gestation. Maternal demographics and fetal/infant cardiac function indices were compared between the groups. Correlation coefficient (r) is reported.

Main outcome measures: Fetal/infant cardiac function indices.

Results: Compared with no-bariatric neonates, offspring of post-bariatric women were smaller at birth (birthweight centiles: 64.96 ± 36.41 versus 40.17 ± 27.99; p = 0.007). There were no significant differences in fetal/infant cardiac function indices and perinatal cardiac changes, between groups. There was a positive correlation between maternal HbA1c and fetal left ventricular (LV) longitudinal strain (r = 0.33) and LV longitudinal strain rate (r = 0.29), suggesting an inverse relation between HbA1c and fetal LV systolic function, but this was mainly seen in offspring of women with no previous bariatric surgery (r = 0.56 and r = 0.50, respectively).

Conclusions: Maternal bariatric surgery does not appear to inadvertently affect the offspring cardiac performance. We found an inverse correlation between maternal HbA1c levels and fetal LV systolic function but this was mainly seen in the no-bariatric pregnancies.

Keywords: bariatric surgery; echocardiography; fetal; pregnancy.

Grants and funding

1169897/CW+