8347 EARLY CHILDHOOD GROWTH FOLLOWING PRE-PREGNANCY METABOLIC AND BARIATRIC SURGERY

Abstract Disclosure: M.J. Hilaire: None. A. Babcock: None. G. White: None. C. Masson: None. C.A. LeDuc: None. V. Thaker: None. Background and Aims: Metabolic and bariatric surgery (MBS) is known to improve metabolic profile. There is conflicting data on the effects of pre-pregnancy MBS on the offspring growth. We aimed to assess offspring early life growth trajectory born to mothers with MBS before conception compared to those who did not. Methods: Records from pregnancies of women who gave birth at Columbia University Irving Medical Center between January 2020 and March 2023 were collected from the clinical databases and electronic health records. The gestational conditions and offspring early life weight, length and BMI trajectory were compared for: pre-pregnancy BMI < 25, BMI 25-35, BMI > 35 and prior MBS. Mixed effect models were used to compare the longitudinal anthropometric trajectories. Sensitivity analyses was done with propensity matching of the pre-pregnancy MBS group by maternal age, parity, pre-pregnancy BMI and race/ethnicity. Results: Of the 22,111 deliveries with data (51% Hispanic/Latino), 455 (76% Hispanic/Latino) had pre-pregnancy MBS- predominantly sleeve gastrectomy (SG, 57%) or Roux-en-Y Gastric Bypass (RYGB, 41%). Antepartum BMI was 32.5 kg/m2 (SD 6.3) for those with pre-pregnancy MBS with 89.8% pregnancies occurring 1-10 years after surgery. There was a higher proportion of multiparous individuals (42% vs 19-31%) in the MBS group. Pre-pregnancy MBS was associated with lower gestational weight-gain, diabetes, and hypertension compared to those with BMI > 35. For offspring, there was no difference in the birth weight, proportion of SGA was higher (6.6% vs 2.5-2.7%, p < 0.01), LGA was lower (2.0% vs 3.6-5.6%, p < 0.01) and NICU admission rate was comparable (20% vs 15-25%). Offspring anthropometric data till age 36 months was available for approximately 50% of the births. Comparison of longitudinal weight trajectories showed no difference in the offspring between those born after RYGB and BMI < 25 kg/m2 (p =0.8), while those born after SG had persistent rise (p =0.04), adjusting for maternal age, parity, time since surgery and race/ethnicity. In the SG group, boys had higher weight trajectories compared to girls. (p < 0.001). The length trajectories and head circumference at birth were similar across groups. Conclusions: Gestational conditions improved with pre-pregnancy MBS. Pre-pregnancy RYGB, but not SG, was followed by favorable offspring weight trajectory that may have a role in long-term metabolic programming. This study is limited by lack of availability of information on pregnancy glycemic profiles, eating behaviors, dietary patterns, and other social determinants of health. Presentation: 6/3/2024