Higher weight gain seen in children of mothers with prepregnancy bariatric surgery

Children born from mothers who underwent metabolic and bariatric surgery (MBS), particularly sleeve gastrectomy, prior to pregnancy appear to have greater weight gain in early life, and this is more pronounced among male offspring, suggests a study. 

In this study, the authors assessed deliveries in a single centre between January 2020 and March 2023 with prepregnancy Roux-en-Y gastric bypass, sleeve gastrectomy, and non-MBS controls. They compared growth trajectories of the offspring with child growth standards set by the World Health Organization. 

Linear mixed models were used to evaluate MBS-bypass and MBS-sleeve offspring’s weight, length, and BMI trajectories with a prepregnancy BMI of 27 to 37 kg/m2 and propensity score-matched controls. 

Overall, 440 women with prepregnancy MBS (MBS-bypass, n=185; MBS-sleeve, n=225; 76 percent Hispanic/Latino) and 13,434 non-MBS controls were included in the analysis. 

Gestational weight gain and gestational diabetes mellitus did not differ between groups, but hypertensive disorders of pregnancy occurred more frequently following MBS. 

Notably, children born to mothers who underwent MBS had lower birth weight but higher weight gain at 24 months (sleeve: 1.4 kg, 95 percent confidence interval [CI], 1.0–1.9; bypass: 0.5–0.7 kg, 95 percent CI, 0.0–1.2) compared with those in the non-MBS group. In addition, male children gained more weight than female children. 

BMI z scores were also higher in the post-MBS-sleeve, but not the post-MBS-bypass, offspring. 

“The higher early-life weight gain and sex differences in the post-MBS-sleeve group compared with the post-MBS-bypass group provide a window toward elucidating pathways to mitigate intergenerational metabolic risk transfer,” the authors said.