A Review of Obstetrical Outcomes and Complications in Pregnant Women after Bariatric Surgery

Haseeb, Yasmeen A

doi:10.18295/squmj.2019.19.04.003

Cited by 10 publications

(13 citation statements)

References 57 publications

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“…The analysis presented an increase in the number of CS, from 24.3% to 31.9%, with a decrease in urgent CS of 5%. Most studies present an increase in the rate of CS after bariatric surgery [12,20], although some researchers observed the opposite [2]. In our study, we also observed an increase in number of scheduled CS with a decrease in proportion of urgent CS.…”

Section: Discussionsupporting

confidence: 72%

“…They can also influence the incidence and course of pregnancy-induced co-morbidities. Bariatric surgery is known to have influence on the pregnancy and neonatal outcomes, increasing the rate of small for gestational age (SGA) infants and maternal anemia and decreasing the risk of GDM, PIH and large for gestational age infants (LGA) infants [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes—A Case-Control Study

Różańska-Walędziak

Bartnik

Janik

et al. 2020

JCM

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Introduction: Obesity in pregnant women increases the incidence of pregnancy-induced comorbidities and the rate of operative deliveries. Purpose of the Study: As bariatric surgery is the reference method of treatment of obesity, we wanted to evaluate its influence on the course of pregnancy and perinatal outcomes. Material and Methods: Data was collected from 627 female patients after bariatric surgery, of whom 107 had a history of pregnancy after the surgery, and 345 non-bariatric patients who had a delivery at a tertiary perinatal center. Sixty-one cases were matched (1:1) with controls for age, pre-pregnancy BMI and presence of pre-pregnancy comorbidities. The main endpoints were gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), small (SGA) and large for gestational age infants (LGA) and cesarean sections (CS). Results: Patients after bariatric procedures were significantly less likely to have GDM (19.67%/37.7%; p = 0.0433), PIH (11.47%/16.39%; p = 0.6072) and preterm delivery (13.11%/37.7%; p = 0.0026). The CS rate was higher (57.38%/40.98%; p = 0.0987). There was an increased risk of SGA (18.03%/13.11%; p = 0.6072) and a decreased risk of LGA (6.56%/16.39%; p = 0.146). Conclusions: Patients after bariatric surgery have a decreased risk of pregnancy-induced comorbidities, preterm deliveries and LGA infants, with an increase in rate of CS and SGA infants compared to general population matched for pre-pregnancy BMI, age and presence of pre-pregnancy comorbidities.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes—A Case-Control Study

Różańska-Walędziak

Bartnik

Janik

et al. 2020

JCM

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“…8 The surrounding literature is growing but remains weak, especially regarding the long-term effect on the children born to women who underwent MBS. [9][10][11][12][13] Consistent results show that MBS is associated with a reduced risk of gestational diabetes, 14,15 LGA neonates, hypertensive disorders, 16,17 and delivery outcomes; 18 however, the benefit to the newborn remains debated considering the potential risk of preterm birth and small for gestational age (SGA) infants. 14,19 Whether MBS has other benefits or risks remains largely unknown.…”

mentioning

confidence: 99%

Risk-Benefit Balance Associated With Obstetric, Neonatal, and Child Outcomes After Metabolic and Bariatric Surgery

et al. 2023

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ImportanceMetabolic and bariatric surgery (MBS) is the most efficient therapeutic option for severe obesity. Most patients who undergo MBS are women of childbearing age. Data in the scientific literature are generally of a low quality due to a lack of well-controlled prospective trials regarding obstetric, neonatal, and child outcomes.ObjectiveTo assess the risk-benefit balance associated with MBS around obstetric, neonatal, and child outcomes.Design, Setting, and ParticipantsThe study included 53 813 women on the French nationwide database who underwent an MBS procedure and delivered a child between January 2012 and December 2018. Each women was their own control by comparing pregnancies before and after MBS.ExposuresThe women included were exposed to either gastric bypass or sleeve gastrectomy.Main Outcomes and MeasuresThe study team first compared prematurity and birth weights in neonates born before and after maternal MBS with each other. Then they compared the frequencies of all pregnancy and child diagnoses in the first 2 years of life before and after maternal MBS with each other.ResultsA total of 53 813 women (median [IQR] age at surgery, 30 [26-35] years) were included, among 3686 women who had 1 pregnancy both before and after MBS. The study team found a significant increase in the small-for-gestational-age neonate rate after MBS (+4.4%) and a significant decrease in the large-for-gestational-age neonate rate (−12.6%). The study team highlighted that compared with pre-MBS births, after MBS births had fewer occurrences of gestational hypertension (odds ratio [OR], 0.16; 95% CI, 0.10-0.23) and gestational diabetes for the mother (OR, 0.39; 95% CI, 0.34-0.45), as well as fewer birth injuries to the skeleton (OR, 0.27; 95% CI, 0.11-0.60), febrile convulsions (OR, 0.39; 95% CI, 0.21-0.67), viral intestinal infections (OR, 0.56; 95% CI, 0.43-0.71), or carbohydrate metabolism disorders in newborns (OR, 0.54; 95% CI 0.46-0.63), but an elevated respiratory failure rate (OR, 2.42; 95% CI, 1.76-3.36) associated with bronchiolitis.Conclusions and RelevanceThe risk-benefit balance associated with MBS is highly favorable for pregnancies and newborns but may cause an increased risk of respiratory failure associated with bronchiolitis. Further studies are needed to better assess the middle- and long-term benefits and risks associated with MBS.

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“…BS and the following reduction of body weight leads to an important decrease in the rate of GDM, when compared to the obese population, and in some studies even to the general non-obese population. The vast majority of studies on the influence of BS on the pregnancy course confirm a significant reduction in the incidence of GDM after BS [ 30 , 42 , 70 , 71 ]. Johansson et al found a more than three-fold reduction of the incidence of GDM in patients after BS compared to the obese population, and the results were corroborated in an analysis by Burke et al [ 44 , 72 ].…”

Section: Gestational Diabetes Mellitusmentioning

confidence: 99%

Pregnancy after bariatric surgery - a narrative literature review.

Różańska-Walędziak

Bartnik

Czajkowski

2020

Videosurgery and Other Miniinvasive Techniques

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The purpose of this review was to analyze the literature about pregnancy after bariatric surgery. We searched for available articles on the subject from the last decade (2010 to 2020). The positive impact of bariatric surgery on the level of comorbidities and pregnancy and neonatal outcomes cannot be overrated. Weight loss after bariatric surgery reduces the incidence of obesity-related conditions in pregnancy. A pregnancy in a woman after bariatric surgery should be considered a high-risk pregnancy and taken care of by a multidisciplinary team with appropriate micronutrient and vitamin supplementation provided. Optimum time to conception should be chosen following the international recommendations. Every woman after bariatric surgery should be aware of symptoms of surgical complications and immediately contact their surgeon in case of abdominal pain.

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A Review of Obstetrical Outcomes and Complications in Pregnant Women after Bariatric Surgery

Cited by 10 publications

References 57 publications

The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes—A Case-Control Study

The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes—A Case-Control Study

Risk-Benefit Balance Associated With Obstetric, Neonatal, and Child Outcomes After Metabolic and Bariatric Surgery

Pregnancy after bariatric surgery - a narrative literature review.

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