Maternal Malnutrition During Pregnancy Among Women with Metabolic and Bariatric Surgery

As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS.

This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression.

Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aOR_Black = 6.35, 95% CI 4.97-8.13; aOR_white = 8.25, 95% CI 7.00-9.73; aOR_Latina = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy.

The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.