Maternal and Perinatal Outcomes After Bariatric Surgery: a Spanish Multicenter Study

Abstract

Pregnancy should be scheduled at least 1 year after BS. Malabsorptive procedures are associated to a higher rate of SGA births.

Pregnancy after Two Different Modalities of Bariatric Surgery. What to Expect?

“…Recommendations advice patients to wait for at least two years after such surgery before conception, which is explained by rapid weight loss and nutritional deficiency develop during this period. (22)(23)(24) In our study, the mean time interval (months) between bariatric surgery and pregnancy was 19.8±3.98 in restrictive group compared to 23.4±4.02 in malabsorptive group (p=0.189). This is consistent with most publications as the time lapse between bariatric surgery and pregnancy ranges from 21 to 57 months and the mean interval is more than 18 months.…”

“…(21,22,27,28) The pre-gestational BMI has a negative impact on obstetric outcome, the mean BMI of the participants at the beginning of pregnancy was 32.8±2.96 vs.29.8±2.75 in group (A) and (B) respectively (P= 0.412) which is in agreement with several studies reported that pre-gestational BMI was between 30 and 34 kg/m2. (16,(23)(24)(25)29) The risk of abortion increases proportionately to BMI (30,31) ,and decreases following proper surgical or conservative weight loss (32)(33)(34) Our data showed 15.9% abortion rate, while it ranges between 15.3 % and 38.9% in general publications. (26,29,(34)(35)(36) Microelements and vitamins requirements are increased during pregnancy particularly following bariatric surgery, and their deficiencies can be prevented before and during pregnancy by adequate supplementations and monitoring.…”

“…González et al, in a recent publication reported 60.7% iron deficiency, 40.5% 25-OH-D3 deficiency, 22.6% B12 deficiency, 6.6%, calcium deficiency, and 5.4% folic acid deficiency. (23) Another study published by Bebber et al on 39 pregnant women who had undergone bariatric surgery reported a rate of 53.4% vitamin B12 deficiency, and 16.1%, folic acid deficiency. (36) Microelements deficiency could be explained by emesis gravidarum, decreased gastric acid production, malabsorption, or decreased intake of some food due to intolerance and consequently appropriate maternal nutrition and supplementation is fundamental.…”

“…This is consistent with most publications as the time lapse between bariatric surgery and pregnancy ranges from 21 to 57 months and the mean interval is more than 18 months. (23)(24)(25)(26) Recently several studies reported that pregnancy following bariatric surgery earlier than 18 months have the same impact on maternal and perinatal outcomes. (21,22,27,28) The pre-gestational BMI has a negative impact on obstetric outcome, the mean BMI of the participants at the beginning of pregnancy was 32.8±2.96 vs.29.8±2.75 in group (A) and (B) respectively (P= 0.412) which is in agreement with several studies reported that pre-gestational BMI was between 30 and 34 kg/m2.…”

“…Several studies have reported a reduction in GDM after bariatric surgery (0%-8.9%), but there were insignificant differences in the prevalence of GDM when compared to women with similar BMI. (16,21,(23)(24)(25)(26)(27) Beenet et al reported 2.5% pregnancy-associated hypertensive disorders (PAHD), and 3% preeclampsia (40) , while Aricha-Tamir et al published that the incidence of PAHD was 16.5%. (26) Moreover, Cafaro et al reported significant lower incidence of gestational hypertension 8.2% and preeclampsia 2.7%.…”