Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study
Abstract Background Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on t...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-06407-0 |
| _version_ | 1797219550296539136 |
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| author | Brit Torunn Bechensteen Cindhya Sithiravel Ellen Marie Strøm-Roum Heidi Kathrine Ruud Gunnhild Kravdal Jacob A. Winther Tone G. Valderhaug |
| author_facet | Brit Torunn Bechensteen Cindhya Sithiravel Ellen Marie Strøm-Roum Heidi Kathrine Ruud Gunnhild Kravdal Jacob A. Winther Tone G. Valderhaug |
| author_sort | Brit Torunn Bechensteen |
| collection | DOAJ |
| description | Abstract Background Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on the optimal nutritional monitoring and supplementation strategies in pregnancy following bariatric surgery. We aimed to assess the impact of bariatric surgery on micronutrients in post-bariatric pregnancy and possible differences between gastric bypass surgery and sleeve gastrectomy. Methods In this prospective case control study, we recruited 204 pregnant women (bariatric surgery n = 59 [gastric bypass surgery n = 26, sleeve gastrectomy n = 31, missing n = 2] and controls n = 145) from Akershus university hospital in Norway. Women with previous bariatric surgery were consecutively invited to study participation at referral to the clinic for morbid obesity and the controls were recruited from the routine ultrasound screening in gestational week 17–20. A clinical questionnaire was completed and blood samples were drawn at mean gestational week 20.4 (SD 4.5). Results The women with bariatric surgery had a higher pre-pregnant BMI than controls (30.8 [SD 6.0] vs. 25.2 [5.4] kg/m2, p < 0.001). There were no differences between groups regarding maternal weight gain (bariatric surgery 13.3 kg (9.6) vs. control 14.8 kg (6.5), p = 0.228) or development of gestational diabetes (n = 3 [5%] vs. n = 7 [5%], p = 1.000). Mean levels of vitamin K1 was lower after bariatric surgery compared with controls (0.29 [0.35] vs. 0.61 [0.65] ng/mL, p < 0.001). Multiadjusted regression analyses revealed an inverse relationship between bariatric surgery and vitamin K1 (B -0.26 ng/mL [95% CI -0.51, -0.04], p = 0.047) with a fivefold increased risk of vitamin K1 deficiency in post-bariatric pregnancies compared with controls (OR 5.69 [1.05, 30.77] p = 0.044). Compared with sleeve gastrectomy, having a previous gastric bypass surgery was associated with higher risk of vitamin K1 deficiency (OR 17.1 [1.31, 223.3], p = 0.030). Conclusion Post-bariatric pregnancy is negatively associated with vitamin K1 with a higher risk of vitamin K1 deficiency in pregnancies after gastric bypass surgery compared with after sleeve gastrectomy. Vitamin K1 deficiency in post-bariatric pregnancy have potential risk of hypocoaguble state in mother and child and should be explored in future studies. |
| first_indexed | 2024-04-24T12:35:26Z |
| format | Article |
| id | doaj.art-bcd7488fc08c4307a9221c613339b579 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-24T12:35:26Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-bcd7488fc08c4307a9221c613339b5792024-04-07T11:33:43ZengBMCBMC Pregnancy and Childbirth1471-23932024-04-0124111010.1186/s12884-024-06407-0Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control studyBrit Torunn Bechensteen0Cindhya Sithiravel1Ellen Marie Strøm-Roum2Heidi Kathrine Ruud3Gunnhild Kravdal4Jacob A. Winther5Tone G. Valderhaug6Department of Endocrinology, Akershus University Hospital HFMultidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital HFDepartment of Gynecology, Akershus University Hospital HFDepartment of Clinical nutrition, Akershus University Hospital HFMultidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital HFDepartment of Endocrinology, Akershus University Hospital HFDepartment of Endocrinology, Akershus University Hospital HFAbstract Background Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on the optimal nutritional monitoring and supplementation strategies in pregnancy following bariatric surgery. We aimed to assess the impact of bariatric surgery on micronutrients in post-bariatric pregnancy and possible differences between gastric bypass surgery and sleeve gastrectomy. Methods In this prospective case control study, we recruited 204 pregnant women (bariatric surgery n = 59 [gastric bypass surgery n = 26, sleeve gastrectomy n = 31, missing n = 2] and controls n = 145) from Akershus university hospital in Norway. Women with previous bariatric surgery were consecutively invited to study participation at referral to the clinic for morbid obesity and the controls were recruited from the routine ultrasound screening in gestational week 17–20. A clinical questionnaire was completed and blood samples were drawn at mean gestational week 20.4 (SD 4.5). Results The women with bariatric surgery had a higher pre-pregnant BMI than controls (30.8 [SD 6.0] vs. 25.2 [5.4] kg/m2, p < 0.001). There were no differences between groups regarding maternal weight gain (bariatric surgery 13.3 kg (9.6) vs. control 14.8 kg (6.5), p = 0.228) or development of gestational diabetes (n = 3 [5%] vs. n = 7 [5%], p = 1.000). Mean levels of vitamin K1 was lower after bariatric surgery compared with controls (0.29 [0.35] vs. 0.61 [0.65] ng/mL, p < 0.001). Multiadjusted regression analyses revealed an inverse relationship between bariatric surgery and vitamin K1 (B -0.26 ng/mL [95% CI -0.51, -0.04], p = 0.047) with a fivefold increased risk of vitamin K1 deficiency in post-bariatric pregnancies compared with controls (OR 5.69 [1.05, 30.77] p = 0.044). Compared with sleeve gastrectomy, having a previous gastric bypass surgery was associated with higher risk of vitamin K1 deficiency (OR 17.1 [1.31, 223.3], p = 0.030). Conclusion Post-bariatric pregnancy is negatively associated with vitamin K1 with a higher risk of vitamin K1 deficiency in pregnancies after gastric bypass surgery compared with after sleeve gastrectomy. Vitamin K1 deficiency in post-bariatric pregnancy have potential risk of hypocoaguble state in mother and child and should be explored in future studies.https://doi.org/10.1186/s12884-024-06407-0Morbid obesityBariatric surgeryPregnancyMicronutrientsVitamin K1 deficiency |
| spellingShingle | Brit Torunn Bechensteen Cindhya Sithiravel Ellen Marie Strøm-Roum Heidi Kathrine Ruud Gunnhild Kravdal Jacob A. Winther Tone G. Valderhaug Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study BMC Pregnancy and Childbirth Morbid obesity Bariatric surgery Pregnancy Micronutrients Vitamin K1 deficiency |
| title | Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study |
| title_full | Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study |
| title_fullStr | Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study |
| title_full_unstemmed | Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study |
| title_short | Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study |
| title_sort | post bariatric pregnancy is associated with vitamin k1 deficiency a case control study |
| topic | Morbid obesity Bariatric surgery Pregnancy Micronutrients Vitamin K1 deficiency |
| url | https://doi.org/10.1186/s12884-024-06407-0 |
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