Research in recent years has shown that gastric bypass before pregnancy may help reduce the risk of certain pregnancy complications. However, some of the benefits of gastric surgery may come at serious cost to the health of the baby. A case study presented at the American Academy of Pediatrics National Conference on October 3, 2010 shows that gastric bypass during adolescence may increase the baby's risk of developing neural tube defects.
The Role of Folic Acid to Prevent Neural Tube Defects
Health care providers and scientists have for many years explained the importance of folic acid during pregnancy. If mothers do not get adequate quantities of this B vitamin, either through diet and/or with the help of prenatal vitamins, it has been shown to dramatically increase their baby's chance of developing a neural tube defect such as spina bifida or anencephaly.
Since the development of the baby's brain and spinal cord occur in the earliest weeks of pregnancy, current the recommendation for women planning to become pregnant is to begin taking folic acid several months or even up to a year before planning to conceive. Research has shown that in order to reduce the chances of neural tube defects, most women who have not had gastric bypass will need between 400-800 mcg of folic acid before and during pregnancy.
Gastric Bypass and Lack of Nutrient Absorption
Research has shown that gastric bypass surgery affects the absorption of several nutrients. This can lead to deficiencies in these much-needed healthy vitamins and minerals. During pregnancy, when vital nutrients cannot be adequately absorbed into the mother's bloodstream, it means that the baby will also be getting less of those nutrients.
In the case of folic acid, researchers are discovering that gastric bypass restricts the levels of this crucial vitamin in early pregnancy. Clearly malabsorption and the subsequent deficiency of folic acid is the reason why women are at an increased risk of having a baby with a neural tube defect.
Babies Born to Teens More at Risk after Gastric Bypass
According to the study authors, there have been at least seven reported cases to date of babies born with neural tube defects to mothers who had had gastric bypass prior to pregnancy. Researchers believe that teens who have had gastric bypass are more at risk for having a baby born with a neural tube defect for several reasons.
One is that adolescents are much more likely to have unintended pregnancies. As a result, teens are also much less likely to be getting the proper nutrients in their diet, such as folic acid, that are needed in the early weeks of pregnancy.
Should Gastric Bypass be Stopped for Adolescent Girls?
Dr. Diana Farmer, Chief of Pediatric Surgery at UCSF who presented the research at the AAP Conference in San Francisco is so concerned about the potential negative effects of gastric bypass for adolescents girls who may become pregnant, she says that, "Although obesity is epidemic in this country, we believe non-reversible gastric bypass surgery should be avoided in adolescent women given the potential increased risk of fetal neural tube defects."
References:
WomensHealth.gov, Folic Acid, FAQ
"Neural Tube Defects: An Unforseen Consequence of Gastric Bypass Surgery in Young Female Patients?"
Katrine M. Lofberg, Diana L. Farmer, Elizabeth A. Gress, Robert H. Lustig, and Melvin B. Heyman.
American Academy of Pediatrics, National Conference and Exhibition, Sunday, 3 October 2010, Abstract No 11611.
Medical News Today, "Could Gastric Bypass in Teenage Girls Be Placing Their Future Children at Risk of Birth Defects?", Oct 4, 2010.
Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.
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