Children Born Before vs After Mom’s Bariatric Surgery: A Study

If a woman has a child before having bariatric surgery, and then another child after having bariatric surgery, are there any notable differences in the health of the children? At The Obesity Society’s annual scientific meeting, John Kral, MD, PhD addressed this question.  Dr Kral began by explaining a paradox: obesity in women is a risk factor for pre-term births, so obese women are more likely to deliver babies who are small for their gestational age. However, these relatively low weight babies are at risk for overcompensating and becoming obese later in life. In addition to being a risk factor for obesity, small size at birth is risk factor for metabolic syndrome, hypertension, and asthma. Moms who have a BMI over 35 are also at higher risk for having a C-section, preterm labor, pre-eclampsia, and still birth. Because of this, there have been studies and treatments designed to try and minimize gestational weight gain (the amount of weight gained when a woman is pregnant) for overweight and obese women. Unfortunately, Dr. Kral said, behavioral and educational interventions designed to reduce gestational weight gain have not shown very good results.

Since bariatric surgery is known to be the most successful treatment of obesity and its associated health conditions, Kral decided to do a comparison of children born to moms before bariatric surgery vs their siblings who were born after bariatric surgery. He found that in the births after the surgery, pregnancy outcomes were much better, and gestational diabetes rates were significantly lower. Additiona, Kral said, kids born to moms after weight loss surgery had lower inflammatory markers, and lower insulin resistance. A gene expression analysis (analysis of how a person’s gene acts) between children born to moms before and after bariatric surgery was done, and showed multiple benefits for the after-surgery children. They had a lower prevalence of obesity and improved cardio-metabolic risk profile, meaning they have less risk of developing negative cardiac and metabolic health conditions.  Excited about bariatric surgery’s ability to have benefit beyond just the mother, Dr Kral concluded that the benefit of treatment of the mom can be transferred her future children.