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Babies born to mothers who have had bariatric surgery are strikingly healthier at birth and throughout childhood than siblings who were born before their mother’s surgery, according to results from a large new study from Quebec.
Even as they grow, children mirror their mother’s metabolic health at the time of childbirth, the study suggests. If the mother’s lipid profile is good and she has a healthy weight when she delivers the baby, that child will have better metabolic
health and less likelihood of gaining weight as he or she grows compared with siblings who were born when their mother was obese.
“Some would say it’s a question of lifestyle but these findings don’t support that. These [metabolic differences between siblings] were noted at birth,” said senior author Picard Marceau, MD, PhD, a surgeon at Laval University in Quebec, Canada.
The results indicate that bariatric surgery—or the weight loss produced by bariatric surgery—dramatically alters the intrauterine environment, resulting in infants who are born at healthier weights than their siblings born before the surgery.
As they grow, these children develop fewer problems with high cholesterol, less fat deposits and less insulin resistance or signs of metabolic disorder than their siblings born before their mother’s surgery, even when the younger children are breastfed the same way and eat similar food quantity and quality as their older brothers and sisters.
Results showed that babies born after surgery carried health advantages from gestation onward compared with their older siblings. During pregnancy, the mothers experienced far fewer complications with no cases of gestational diabetes, eclampsia or hypertension; for babies born before surgery, 12 women developed gestational diabetes, nine had eclampsia and 15 were diagnosed with hypertension. At birth, the infants born after their mothers underwent bariatric surgery weighed 17% less (P<0.001) and had 86% less macrosomia (0.06) than their siblings.
As the children grew, so did the health disparity with their siblings. They were significantly less likely to become obese or severely obese, with a 75% drop in severe obesity when measured by body mass index (BMI) percentile and a 65% decline when measured by BMI z-score. Overall, the children born after their mothers had bariatric surgery had an 11% decrease in BMI percentile, an 11% drop in waist circumference over height, a 38% reduction in BMI z-score and a 20% decrease in fat content compared with their older siblings. They accumulated belly fat five times slower than their older siblings (P=0.01).
What is most striking, said researchers, is the stark contrast in metabolic conditions in children born before and after surgery. Laboratory tests showed a 30% decrease in insulin resistance, 20% decrease in triglycerides, a 12% increase in high-density lipoprotein (HDL) cholesterol and a 13% decline in the ratio of total cholesterol over HDL in the offspring born after their mother’s operation.
“Bariatric surgery before pregnancy significantly improves an obese woman’s chances of giving birth to children who don’t have obesity-related metabolic disorders,” he said.
Surgery can halt the cumulative transmission of obesity from one generation to the next, what Dr. Marceau called a “vicious cycle of obesity.”
“If we are to curb the obesity epidemic, the focus must be on pregnancies,” he said.
The study also showed that boys’ and girls’ bodies responded differently. In boys, the predominant effect was prevention of severe obesity and correction of the lipid metabolism, whereas in girls the greatest effects were improved insulin sensitivity and decreased tissue fat percentage, independent of weight loss.
Even minimal weight loss in an obese woman can significantly improve the health of her children, said Dr. Marceau. “Pregnancy is a time for great investment in life, even if it is minimal weight loss or restrictive diets.”
One point to note is that the study pertains to patients who had undergone Bilio-pancreatic Diversion (BPD in short)– a rare operation. In India, BPD is an unusual procedure indeed, especially in vegetarians who need high amount of proteins in their diet after this operation.
Pic credit: GSN
