Impact of Gestational Weight Gain on Maternal and Perinatal Outcomes After Laparoscopic Sleeve Gastrectomy

Sancak, Seda; Altun, Hasan; Çeler, Özgen; Çırak, Elif; Er, Cansu; Karip, Aziz Bora; Okuroğlu, Nalan; Bulut, Nuriye Esen; Fersahoğlu, Mehmet Mahir; Sertbaş, Yaşar; Memışoğlu, Kemal

doi:10.1007/s11695-022-06305-4

Cited by 4 publications

(4 citation statements)

References 33 publications

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“…Few studies have assessed the impact of different surgical procedures before pregnancy. One study of 119 pregnant women found no effect of maternal weight gain on maternal and perinatal outcome after sleeve gastrectomy [ 46 ]. However, the study did not include pregnancies after gastric bariatric surgery for comparison.…”

Section: Discussionmentioning

confidence: 99%

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Bechensteen,

Sithiravel,

Strøm-Roum

et al. 2024

BMC Pregnancy Childbirth

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Background Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on the optimal nutritional monitoring and supplementation strategies in pregnancy following bariatric surgery. We aimed to assess the impact of bariatric surgery on micronutrients in post-bariatric pregnancy and possible differences between gastric bypass surgery and sleeve gastrectomy. Methods In this prospective case control study, we recruited 204 pregnant women (bariatric surgery n = 59 [gastric bypass surgery n = 26, sleeve gastrectomy n = 31, missing n = 2] and controls n = 145) from Akershus university hospital in Norway. Women with previous bariatric surgery were consecutively invited to study participation at referral to the clinic for morbid obesity and the controls were recruited from the routine ultrasound screening in gestational week 17–20. A clinical questionnaire was completed and blood samples were drawn at mean gestational week 20.4 (SD 4.5). Results The women with bariatric surgery had a higher pre-pregnant BMI than controls (30.8 [SD 6.0] vs. 25.2 [5.4] kg/m2, p < 0.001). There were no differences between groups regarding maternal weight gain (bariatric surgery 13.3 kg (9.6) vs. control 14.8 kg (6.5), p = 0.228) or development of gestational diabetes (n = 3 [5%] vs. n = 7 [5%], p = 1.000). Mean levels of vitamin K1 was lower after bariatric surgery compared with controls (0.29 [0.35] vs. 0.61 [0.65] ng/mL, p < 0.001). Multiadjusted regression analyses revealed an inverse relationship between bariatric surgery and vitamin K1 (B -0.26 ng/mL [95% CI -0.51, -0.04], p = 0.047) with a fivefold increased risk of vitamin K1 deficiency in post-bariatric pregnancies compared with controls (OR 5.69 [1.05, 30.77] p = 0.044). Compared with sleeve gastrectomy, having a previous gastric bypass surgery was associated with higher risk of vitamin K1 deficiency (OR 17.1 [1.31, 223.3], p = 0.030). Conclusion Post-bariatric pregnancy is negatively associated with vitamin K1 with a higher risk of vitamin K1 deficiency in pregnancies after gastric bypass surgery compared with after sleeve gastrectomy. Vitamin K1 deficiency in post-bariatric pregnancy have potential risk of hypocoaguble state in mother and child and should be explored in future studies.

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Section: Discussionmentioning

confidence: 99%

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Bechensteen,

Sithiravel,

Strøm-Roum

et al. 2024

BMC Pregnancy Childbirth

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“…In contrast, maternal insufficient GWG was not associated with the delivery of a SGA neonate in the post-bariatric group. Most of the studies on GWG in post-bariatric pregnant women are retrospective; reported maternal weight at different gestational weeks/times or "the last known weight of pregnancy"; used different control groups, if any; and reported conflicting results [18][19][20][21][22][23][24]. One retrospective study examining the effect of trimester-specific GWG on BW, in women with previous biliopancreatic diversion, found that although women had less GWG, compared to women without surgery, there was still no association between GWG and BW [19].…”

Section: Discussionmentioning

confidence: 99%

“…One retrospective study examining the effect of trimester-specific GWG on BW, in women with previous biliopancreatic diversion, found that although women had less GWG, compared to women without surgery, there was still no association between GWG and BW [19]. Other retrospective studies, including women with laparoscopic adjustable gastric banding, sleeve gastrectomy, or gastric bypass, showed similar GWG between post-bariatric and no surgery women [20,21] when a control group was used, but then again, there was lack of an association between GWG and risk of delivering a SGA neonate [20,22]. In contrast, other retrospective studies have shown an association between GWG and BW [18,24].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have suggested that pregnancy following bariatric surgery is associated with lower rates of LGA neonates but increased rates of SGA neonates and preterm delivery, compared to pregnancies in women with no surgery but booking BMI similar to the early-pregnancy or pre-surgery BMI of the post-bariatric ones [17]. A relatively small number of studies have investigated the effects of maternal GWG on the outcome of postbariatric pregnancies, and especially on birthweight (BW) and increased rates of SGA neonates, seen in this population [18][19][20][21][22][23][24]. However, most of these studies were retrospective and therefore unable to evaluate reliably the role of GWG in this population.…”

Section: Introductionmentioning

confidence: 99%

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Gestational Weight Gain in Pregnancies Following Bariatric Surgery

et al. 2023

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Introduction To compare the gestational weight gain (GWG) between women with previous bariatric surgery and those without and investigate whether GWG correlates with birthweight (BW) or delivery of a small-for-gestational-age (SGA) neonate. Materials and Methods Prospective, longitudinal study, include 100 pregnant women with previous bariatric surgery and 100 without weight loss surgery, but with similar early-pregnancy body mass index (BMI). In a sub-study, 50 of the post-bariatric women were also matched to 50 women without surgery, but early-pregnancy BMI similar to the pre-surgery BMI of the post-bariatric ones. All women had their weight/BMI measured at 11–14 and 35–37 weeks of gestation, and the difference in maternal weight/BMI between the two time points was expressed as GWG/BMI gain. Associations between maternal GWG/BMI gain and birthweight (BW) were examined. Results Compared to no bariatric women with similar early-pregnancy BMI, post-bariatric women had similar GWG (p = 0.46), and the number of women with appropriate, insufficient, and excessive weight gain was comparable between groups (p = 0.76). However, post-bariatric women delivered smaller babies (p < 0.001), and GWG was not a significant predictor of BW or of delivering a SGA neonate. Compared to no bariatric women with similar pre-surgery BMI, post-bariatric ones had higher GWG (p < 0.01) but still delivered smaller neonates (p = 0.001). Conclusions Post-bariatric women seem to have similar or greater GWG compared to women without surgery matched for early-pregnancy or pre-surgery BMI, respectively. Maternal GWG was not associated with BW or higher prevalence of SGA neonates seen in women with previous bariatric surgery. Graphical Abstract

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Midterm Outcome of Early Pregnancy Versus Late Pregnancy After Laparoscopic Sleeve Gastrectomy

Alqahtani,

Almayouf,

Butt

et al. 2024

OBES SURG

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Impact of Gestational Weight Gain on Maternal and Perinatal Outcomes After Laparoscopic Sleeve Gastrectomy

Cited by 4 publications

References 33 publications

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Gestational Weight Gain in Pregnancies Following Bariatric Surgery

Midterm Outcome of Early Pregnancy Versus Late Pregnancy After Laparoscopic Sleeve Gastrectomy

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