Is it necessary to postpone pregnancy after bariatric surgery: a national cohort study

Malakauskienė, Laura; Nadišauskienė, Rūta Jolanta; Ramašauskaitė, Diana; Bartusevičienė, Eglė; Ramonienė, Gitana; Maleckienė, Laima

doi:10.1080/01443615.2019.1634024

Cited by 14 publications

(8 citation statements)

References 26 publications

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“…The weight loss period after bariatric surgery is most significant in the first year and guidelines recommend avoiding pregnancy for at least 12 (12-24) months after bariatric surgery [16,17]. On the other hand, it has been shown that there are similar pregnancy outcomes among women who conceive during and after the first year after bariatric surgery, as in our study [7,18]. There are limited data available on this issue because patients of reproductive age are counselled on contraception postoperatively.…”

Section: Discussionsupporting

confidence: 75%

Early pregnancy after bariatric surgery: a single-institute preliminary experience

Günakan

Buluş²,

Tohma

2020

Turk J Med Sci

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Background/aim: Pregnancy after bariatric surgery is an issue of growing importance with increasing number of women undergoing bariatric surgery. Therefore, in this study we present patients who conceived after sleeve gastrectomy and evaluate the obstetric outcomes. Materials and methods: This retrospective case-control study includes 23 women who conceived after laparoscopic sleeve gastrectomy. Patients were evaluated in two groups according to the number of months between surgery and conception (group 1: ≤12 months; group 2: >12 months). Results: The mean body mass index of patients before surgery and at the time of conception was 46.6 kg/m 2 and 29.7 kg/m 2 , respectively. Nine patients (39.1%) had a history of infertility. There was no statistical difference between groups 1 and 2 for haemoglobin, ferritin, and 25-OH Vit-D levels or maternofoetal complication rates and pregnancy outcomes. Enteral nutrition requirements and intravenous iron replacement needs were higher in group 1, although this difference was not statistically significant. Conclusion: Pregnancy in the first years after sleeve gastrectomy seems to have similar obstetric outcomes compared to pregnancies occurring later, but it remains a controversial issue. Although the results did not have statistical significance in our study, well-designed prospective series may determine the role of enteral nutrition and intravenous iron replacement in patient management.

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Section: Discussionsupporting

confidence: 75%

Early pregnancy after bariatric surgery: a single-institute preliminary experience

Günakan

Buluş²,

Tohma

2020

Turk J Med Sci

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“…Previous studies found no associations between the time from surgery to conception and adverse pregnancy or neonatal outcomes [4,[15][16][17][18][19][20][21][22][23][24]. In fact, most studies confirm that the risk of these outcomes is not increased during the first 12 months after bariatric surgery compared to later pregnancies [4,16,17,19,22,25].…”

Section: Discussionmentioning

confidence: 98%

A Matter of Timing—Pregnancy After Bariatric Surgery

et al. 2021

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Purpose Current guidelines recommend to avoid pregnancy for 12–24 months after bariatric surgery because of active weight loss and an increased risk of nutritional deficiencies. However, high-quality evidence is lacking, and only a few studies included data on gestational weight gain. We therefore evaluated pregnancy and neonatal outcomes by both surgery-to-conception interval and gestational weight gain. Materials and Methods A multicenter retrospective analysis of 196 singleton pregnancies following Roux-en-Y gastric bypass, sleeve gastrectomy, and one anastomosis gastric bypass was conducted. Pregnancies were divided into the early group (≤ 12 months), the middle group (12–24 months), and the late group (> 24 months) according to the surgery-to-conception interval. Gestational weight gain was classified as inadequate, adequate, or excessive according to the National Academy of Medicine recommendations. Results Pregnancy in the early group (23.5%) was associated with lower gestational age at delivery (267.1 ± 19.9 days vs 272.7 ± 9.2 and 273.1 ± 13.5 days, P = 0.029), lower gestational weight gain (− 0.9 ± 11.0 kg vs + 10.2 ± 5.6 and + 10.0 ± 6.4 kg, P < 0.001), and lower neonatal birth weight (2979 ± 470 g vs 3161 ± 481 and 3211 ± 465 g, P = 0.008) than pregnancy in the middle and late group. Inadequate gestational weight gain (40.6%) was associated with lower gestational age at delivery (266.5 ± 20.2 days vs 273.8 ± 8.4 days, P = 0.002) and lower neonatal birth weight (3061 ± 511 g vs 3217 ± 479 g, P = 0.053) compared to adequate weight gain. Preterm births were also more frequently observed in this group (15.9% vs 6.0%, P = 0.037). Conclusion Our findings support the recommendation to avoid pregnancy for 12 months after bariatric surgery. Specific attention is needed on achieving adequate gestational weight gain.

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“…The reason to delay a pregnancy is to prevent adverse outcome, mainly SGA. Several studies reported no difference in prevalence of GDM when comparing an interval shorter or longer than 1 year after bariatric surgery [ 48 , 60 , 68 , 80 , 84 ]. Other studies investigated longer intervals, of up to 2 years, and also showed no difference [ 49 , 57 , 71 , 81 , 87 ].…”

Section: Resultsmentioning

confidence: 99%

Glucose Homeostasis, Fetal Growth and Gestational Diabetes Mellitus in Pregnancy after Bariatric Surgery: A Scoping Review

Deleus

Schueren

Devlieger

et al. 2020

JCM

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Background: Pregnancies in women with a history of bariatric surgery are becoming increasingly prevalent. Surgically induced metabolic changes benefit mother and child, but can also lead to some adverse pregnancy outcomes. Knowledge about glucose homeostasis in these pregnancies could elucidate some of the mechanisms behind these outcomes. This review focusses on glucose homeostasis and birth weight. Methods: We considered papers dealing with glucose homeostasis, gestational diabetes mellitus (GDM) and/or small-for-gestational age infants (SGA) in pregnancies with a history of sleeve gastrectomy (SG) or Roux-en-y gastric bypass (RYGB). Results: Since an OGTT is unreliable to diagnose GDM in a pregnancy after bariatric surgery, the true incidence of GDM is unknown. Alternative screening strategies are needed. Furthermore, these pregnancies are marked by frequent hypoglycemic events as well as wide and rapid glycemic excursions, an issue that is very likely underreported. There is a lack of uniformity in reporting key outcomes and a large variation in study design and control population. Conclusion: Alteration of glucose homeostasis in a pregnancy after bariatric surgery should be further studied using unequivocal definition of key concepts. Glycemic control may prove to be a modifiable risk factor for adverse pregnancy outcomes such as the delivery of an SGA baby.

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Is it necessary to postpone pregnancy after bariatric surgery: a national cohort study

Cited by 14 publications

References 26 publications

Early pregnancy after bariatric surgery: a single-institute preliminary experience

Early pregnancy after bariatric surgery: a single-institute preliminary experience

A Matter of Timing—Pregnancy After Bariatric Surgery

Glucose Homeostasis, Fetal Growth and Gestational Diabetes Mellitus in Pregnancy after Bariatric Surgery: A Scoping Review

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