Outcomes of Pregnancy after Bariatric Surgery

Abstract

Bariatric surgery was associated with reduced risks of gestational diabetes and excessive fetal growth, shorter gestation, an increased risk of small-for-gestational-age infants, and possibly increased mortality. (Funded by the Swedish Research Council and others.).

Maternal and fetal delivery outcomes in pregnancies following bariatric surgery: a meta-analysis of the literature

“…The 6 studies included in this section found either no difference or an increased risk of SGA neonates among bariatric surgery patients [13,15,[19][20][21]23] while our data suggests an increased risk of SGA among the bariatric surgery woman as compared to the controls. However, this is potentially due to the same reasons as listed above for IUGR.…”

“…The 9 studies used in this review are no exception . While there were 4 papers showing a decrease in the rates of GD [13,16,20,22] , the majority did not show a difference. It has been theorized that there is a reduction in the rates of GD after bariatric surgery due to absorption or metabolic changes [24] .…”

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

“…(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.…”

“…Several observational studies have reported an increased rate of intrapartum complications (14,15) , but perinatal mortality rate is still controversial. (16) Current recommendations advise delaying pregnancy for 12-18 months following bariatric surgery as rapid weight loss occurs in this period. (17) Therefore, it is believed that women after bariatric surgery who become pregnant need to be followed up by multidisciplinary team including a nutritionist, an obstetrician, an endocrinologist, and a bariatric surgeon.…”

Mr. Fertility Authority, Tear Down That Weight Wall!

“…Bariatric surgery results in weight loss in the first 12 months of 30-40%, much more effective than any combination of lifestyle modification and obesity medication, which at best might achieve 10-15% weight loss over the same time period. The data from long-term follow-up of obese women in Sweden using linked registries challenges firmly held convictions about the benefit of weight loss on perinatal outcomes (Johansson et al, 2015). Compared to matched obese control women, women who underwent bariatric surgery were significantly more likely to deliver a small for gestational age infant (15.6% in the bariatric group versus 7.6% in the control; odds ratio, 2.20; 95% CI, 1.64-2.95; P < 0.001).…”