August 2017
/Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons.
BMI was measured at first prenatal visit and classified into groups and risk of major congenital malformations ascertained at 1 year. Compared with offspring of normal weight mothers (risk of malformations 3.4%), the proportions and adjusted risk ratios of any major congenital malformation among the offspring of mothers with higher BMI were: overweight (BMI 25-30) was 3.5% and 1.05 (95% confidence CI 1.02 to 1.07); BMI 30-35, 3.8% and 1.12 (1.08 to 1.15), BMI 35-40 4.2% and 1.23 (1.17 to 1.30), and BMI >40, 4.7% and 1.37 (1.26 to 1.49). The greatest risk was associated with CNS malformations. (BMI >40 and 1.88 (1.2-2.94).
Bariatric Surgery in Women of Childbearing Age, Timing Between an Operation and Birth, and Associated Perinatal Complications.
A retrospective cohort study including 1859 women with a history of bariatric surgery. Infants from mother with a history of surgery had a higher risk for prematurity, NICU admission, SGA status and low Apgar score. Risk was highest when the operation to birth interval was less than a 2-years.
Updated Etiology and Significance of Elevated Bilirubin During Pregnancy: Changes Parallel Shift in Demographics and Vaccination Status
Dig Dis Sc (2017) 62 (2):517-525
Although viral hepatitis is considered a leading cause of elevated bilirubin, this prospective study of 80,000 deliveries found the most common cause was gallstones (25%), pre-eclampsia (24%) and intrahepatic cholestasis (13%). Stillbirths, fetal malformations, neonatal deaths, and small for gestational age births, were more common in the women with hyperbilirubinemia during pregnancy