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WLS in Teenage Girls May Raise Birth Defect Risk

Teenage girls who have weight loss surgery before pregnancy -- have higher risks of having babies with birth defects.  Why?  Weight loss surgery creates malabsorption of nutrients -- PARTICULARLY THE B VITAMINS -- and teenagers do not follow through with their vitamin supplementation as well as adults do.  

It seems that this issue should be obvious, as we knew that the vitamin absorption in bypassed patients was not particularly great?  

But, obviously, it's appearing more BABIES now.  Babies of the bypassed.

(And, yes, we are totally aware that obesity brings risks to pregnancy.  I was a statistic too, even at my very young age, pregnancies with super high blood pressure, bed rest and fun!)

My "bypass baby" -- I swore she would have a neural tube defect.  

Neural tube defects (NTDs) are one of the most common birth defects, occurring in approximately one in 1,000 live births in the United States. An NTD is an opening in the spinal cord or brain that occurs very early in human development. The early spinal cord of the embryo begins as a flat region, which rolls into a tube (the neural tube) 28 days after the baby is conceived. When the neural tube does not close completely, an NTD develops. NTDs develop before most women know they are even pregnant.

Neural tube defects are birth defects of the brain and spinal cord. The two most common neural tube defects are spina bifida and anencephaly. In spina bifida, the fetal spinal column doesn't close completely during the first month of pregnancy. There is usually nerve damage that causes at least some paralysis of the legs. In anencephaly, much of the brain does not develop. Babies with anencephaly are either stillborn or die shortly after birth.

Getting enough folic acid, a type of B vitamin, before and during pregnancy prevents most neural tube defects. Treatments for neural tube defects vary depending on the type of defect.

NIH: National Institute of Child Health and Human Development

Yes, I thought it.  I thought it DAILY until we saw the ultrasound.  In fact, I was pregnant and miscarried previous to her gestation, and I was counseled to abort -- because of my "nutritional status."

Bottom line - TAKE YOUR VITAMINS.  If you want to have a healthy baby in the future -- don't skimp NOW -- TAKE YOUR VITAMINS.  Even if you're 18, 21, or 25 and babies aren't in your near future -- and you're not worried -- TAKE YOUR VITAMINS.  And?  Take your vitamins.

(PS.  My baby was/is fine.  I wasn't so much.)

Bloomberg -

Teenage girls who’ve undergone obesity surgery may not absorb enough of a vitamin needed to have healthy babies, raising the risk of bearing children with spine and brain birth defects, a study suggests.

While more adolescents are having gastric bypass surgery, little is known about long-term consequences of the procedure, said Diana Farmer, who presented the study today at the American Association of Pediatrics meeting in San Francisco. “The possibility of future birth defects may outweigh the benefit of this bariatric procedure” for adolescent girls, said Farmer, chief of pediatric surgery at Benioff Children’s Hospital at the University of California, San Francisco.

Farmer’s report focuses on two converging trends -- rising rates of adolescent obesity and gastric bypass surgery to combat it. Since 2001, the number of gastric bypasses and other bariatric procedures has risen sixfold, with 220,000 of them done in 2009, according to the American Society of Metabolic and Bariatric Surgery in Gainesville, Florida. About 17 percent of children and adolescents ages 2 to 19 are obese, according to the Centers for Disease Control and Prevention in Atlanta.

“I am not saying the procedure should be ruled out or that obesity is not a problem,” Farmer said in a telephone interview Oct. 1. “But no kids are dropping dead at the age of 18 from obesity.”

Gastric bypass surgery involves sidestepping the upper intestine, which limits the amount of food a person can consume. Other bariatric surgery includes gastric banding that restricts the size of the opening from the esophagus to the stomach.

Vitamin Supplements

Farmer’s report highlights a consequence of gastric bypass surgery that leads to insufficient absorption of Vitamin B9, or folic acid, which occurs in the upper intestine. Folate, or folic acid, is a key element in the prevention of spina bifida and other neural tube defects. Patients who undergo the procedure are placed on vitamin supplements to counteract the reduction. Limited research shows adherence to the supplements by teens is 14 percent, according to Farmer’s presentation.

“You can’t just write off these birth defects because they are rare,” said Bruce Wolfe, a Portland, Oregon, surgeon and president of the bariatric surgery association. “But there are adverse effects from the obesity as well. So the practical and ethical dilemma is at what point do you deny a tremendously beneficial procedure.”

To contact the reporter on this story: Pat Wechsler in New York at pwechsler@bloomberg.net

  • http://www.aap.org/
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