Case Report of a Healthy Pregnancy in a Woman of Advanced Maternal Age at Sixteen Months Post-Roux-en-Y Gastric Bypass Revision

Abstract

Background/Objective: Obesity (body mass index > 30 kg/m2) complicates maternal and neonatal pregnancy outcomes. Bariatric surgery (BS) is an option for weight reduction in reproductive-aged women. However, there is a lack of data regarding the ideal time interval between BS and pregnancy. Methods:We report the case of a 43-year-old Hispanic female who underwent an initial Roux-en-Y gastric bypass (RYGB) in 2011 followed by a revision eight years later in 2019. The revision occurred 16 months prior to conception of her second pregnancy. Results: Despite advanced maternal age and nutritional challenges following BS, she delivered a healthy male baby and sustained a net weight loss compared to her preoperative weight. Factors leading to this positive outcome included the patient’s adherence to dietary recommendations following the procedure and the use of phentermine to promote post-procedure weight loss. Conclusion: An interval of sixteen months between RYGB revision and conception can lead to positive pregnancy outcomes, even in women of advanced maternal age. Adherence to post-procedure nutrition and weight gain protocols are crucial to this outcome. Further studies are needed to explore the time interval that ensures a healthy pregnancy, as well as the use of medications as weight loss adjuncts following BS.