Babies born to teenage girls who become pregnant after gastric bypass surgery may have a higher risk of birth defects.
The finding is based on a small number of cases, and some researchers doubt the link. Surgery that rearranges the stomach and intestines can reduce the absorption of some vitamins and nutrients from food. This may affect the development of the baby's brain and spinal cord, and the baby may be born with a neural tube defect, such as a spinal canal that hasn't closed completely.
It is well known that a lack of folic acid (folate) raises the risk of neural tube defects.
Women of any age who have had gastric bypass surgery may be at risk of vitamin deficiencies. The concern is greater for teenagers who become pregnant, because they may be less likely than adults to follow nutrition advice: teenagers are known to be less willing to comply, often don't do what they say about taking medicines or what their parents tell them, and so may not take the right pregnancy vitamins.
The number of teenagers having this operation has doubled in the past three years, so they need to be aware of its risks.
Not all researchers agree that the surgery leads to folate deficiency. Dr Thomas says: "We have successfully treated more than a hundred teenagers and followed them for several years, and they did not have low folate levels after surgery. Food in the United States is fortified with folate, and birth defects caused by folate deficiency have fallen since fortification began."
He added: "Obesity causes problems in pregnancy, and most of the evidence suggests that a woman is safe, not at risk, when she becomes pregnant after gastric bypass surgery."
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