With more obese teenage girls undergoing gastric bypass surgery, there is growing concern about a possible increased risk of having babies later on with disabilities, such as mental retardation or paralysis, as a result of damage to their nervous system, researchers explained at the American Academy of Pediatrics National Conference. Specifically, the risk relates to neural tube defects in the brain and spinal cord.

Researcher, Diana L. Farmer, MD, explained that neural tube defects can be a consequence of nutritional deficiencies.

Dr. Farmer and team reviewed the case of a young female who had undergone gastric bypass surgery, and later became pregnant. As her fetus had spina bifida, she had arrived at the Fetal Treatment Center at UCSF Benioff Children's Hospital to talk about the possibility of fetal surgery.

After carrying out a review, the researchers discovered six more documented cases of babies born with neural tube defects which were probably caused by nutritional deficiencies - in all cases their mothers had undergone gastric bypass surgery during their teenage years.

The scientists believe the neural tube defects occur because the body cannot absorb nutrients properly after bypass surgery.

Medical professionals know that one of the consequences of gastric bypass surgery is malabsorbtion, which can cause a number of deficiencies, including not enough folic acid. Folic acid is a vital element during pregnancy in preventing neural tube defects in the developing baby.

Dr. Farmer explained that daily folate replacement can make up for this deficiency. Unfortunately, a significant number of adolescents do not adhere to (comply with) medication regimens - they forget to take the tablets.

As adolescents are more likely to become pregnant after gastric bypass surgery, this situation is especially critical.

Dr. Farmer said:

We postulate that the malabsorption of folate, poor compliance with nutritional supplements and a higher risk of unintended pregnancies places young women at an increased risk for pregnancies complicated with neural tube defects.

Although obesity is epidemic in this country, we believe non-reversible gastric bypass surgery should be avoided in adolescent women given the potential increased risk of fetal neural tube defects," Farmer said. "If gastric bypass is performed on an adolescent female, great efforts must be made to minimize the risks of both unintended pregnancies and nutritional deficiencies. This should include extensive pre-surgery counseling and frequent post-operative follow-up, as well as consideration of highly efficacious contraceptives such as an intrauterine device.

The study report is called "Neural Tube Defects: An Unforseen Consequence of Gastric Bypass Surgery in Young Female Patients?"

Source: American Academy of Pediatrics