Iron Deficiency Anemia in Pregnancy after Bariatric Surgery: Etiology, Risk Factors, and How to Manage It

Amaral-Moreira, Carolina de Freitas Alves; Redezuk, Guilherme; Pereira, Belmiro Gonçalves; Borovac-Pinheiro, Anderson; Rehder, Patricia Moretti

doi:10.1055/s-0043-1776026

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…For instance, the serum level of vitamin B1 decreases during normal pregnancy, but this decrease is more pronounced in pregnancies after bariatric surgery [ 43 ]. Hemoglobin concentration, ferritin, and average blood volume also decrease during normal pregnancy due to hemodilution, while pregnancy after bariatric surgery can lead to iron deficiency due to reduced meat consumption and intestinal iron absorption capacity [ 44 ]. Nutritional deficiencies during pregnancy after bariatric surgery can have serious consequences for the baby.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

Navaee,

Kashanian,

Kabir

et al. 2024

Reprod Health

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Background Being obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery. Methods In this study Pregnant women (< 14 weeks’ gestation) (n = 38 per group) are recruited either from one of the obesity clinic (exposure group = with a history of bariatric surgery) or primary healthcare clinics in Tehran city (comparison group = pregnant women with obesity and and no history of bariatric surgery). Dietary intake and nutrient status are assessed at < 14, 28, and 36 weeks. Maternal and fetal/neonatal outcomes are compared between the two groups, including gestational diabetes, preeclampsia, preterm labor, intrauterine growth restriction, severe nausea and vomiting, abortion, placenta previa and abruption, venous thrombosis, vaginal bleeding, cesarean delivery, meconium aspiration, and respiratory distress. Maternal serum levels of ferritin, albumin, zinc, calcium, magnesium, selenium, copper, vitamins A, B9, B12, and 25-hydroxy Vit D are checked during 24th to 28th weeks. Maternal and neonatal outcomes, including height, weight, head circumference, fetal abnormality, infection, small or large fetus, low birth weight, macrosomia, NICU admission, and total weight gain during pregnancy, are measured at birth. Maternal and offspring outcomes, including weight, height, head circumference, total weight gain during pregnancy, newborn diseases, postpartum bleeding, breastfeeding, and related problems, are assessed 6 weeks after delivery. Child's weight, height, and head circumference are followed at 2, 4, 6, 8, 10, and 12 months after birth. Maternal stress, anxiety, and depression are assessed with the DASS-21 questionnaire, and physical activity is evaluated using the PPAQ questionnaire in the first and third trimesters. Discussion By assessing the levels of micronutrients in the blood of pregnant women along with the evaluation of pregnancy outcomes, it is feasible to gain a more accurate understanding of how bariatric surgery affects the health and potential complications for both the mother and the fetus/newborn. This information can help specialists and patients make more informed decisions about the surgery. Additionally, by examining issues such as stress, anxiety, and depression in women undergoing surgery, this study can contribute to recognizing these problems, which can also affect pregnancy outcomes.

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Section: Introductionmentioning

confidence: 99%

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

Navaee,

Kashanian,

Kabir

et al. 2024

Reprod Health

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Iron Treatment in Patients with Iron Deficiency Before and After Metabolic and Bariatric Surgery: A Narrative Review

Kaberi-Otarod,

Still,

Wood

et al. 2024

Nutrients

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Iron is an essential nutrient in living organisms with multiple vital functions. Iron deficiency (ID) can cause long term health consequences beyond iron deficiency anemia (IDA). The high prevalence of ID and its long-term effects in patients with obesity and after metabolic and bariatric surgery (MBS) is recognized. Nevertheless, there is limited knowledge of the optimal route or dose for treatment of patients with obesity and post-MBS, and an evidence-based universal guideline for prevention and treatment of ID in short- and long-term PMBS is not yet available. ID in the general population is currently treated with oral or parenteral iron, where oral iron treatment is considered the preferred option with parenteral iron as a second-line treatment in case there is intolerance or lack of response to oral iron. In patients with obesity with chronic low-grade inflammation and patients post-MBS (PMBS) with altered gut anatomy and function, there are also alterations in the bioavailability and higher risks of side effects of available oral irons. The conclusions of current studies exploring effective treatment of iron deficiency in this population have been inconsistent and further well-planned randomized and prospective studies are needed. This is a narrative review of the literature on the available treatment options and strategies for treatment of ID in PMBS patients to recognize the knowledge gaps and provides topics of future research.

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Anemia Ferropriva E Atipicidades Gestacionais: Cuidados Médicos Preventivos E Corretivos Necessários

Nascimento,

Silva

2024

Rev. Contemp.

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Um dos períodos mais delicados na vida da mulher é a gestação, durante o qual pode ocorrer uma série de problemas de saúde que colocam em risco o binômio materno-fetal. Considerado um dos problemas gestacionais mais comuns, a anemia ferropriva é causada pela deficiência de ferro no organismo da gestante e, quando não tratada, produz sérios riscos para a saúde e vida da mãe e do filho. OBJETIVO: Analisar as atipicidades produzidas pela anemia ferropriva gestacional que devem ser consideradas pelos cuidados médicos. METODOLOGIA: Revisão bibliográfica, de abordagem qualitativa, natureza básica, objetivos descritivos e procedimento monográfico, realizada com artigos científicos publicados em periódicos entre os anos de 2018 e 2023. INTRODUÇÃO: Um dos períodos mais delicados na vida da mulher é a gestação, durante o qual pode ocorrer uma série de problemas de saúde que colocam em risco o binômio materno-fetal. Considerado um dos problemas gestacionais mais comuns, a anemia ferropriva é causada pela deficiência de ferro no organismo da gestante e, quando não tratada, produz sérios riscos para a saúde e vida da mãe e do filho. OBJETIVO: Analisar as atipicidades produzidas pela anemia ferropriva gestacional que devem ser consideradas pelos cuidados médicos. METODOLOGIA: Revisão bibliográfica, de abordagem qualitativa, natureza básica, objetivos descritivos e procedimento monográfico, realizada com artigos científicos publicados em periódicos entre os anos de 2018 e 2023. RESULTADOS: Ficou demonstrado que anemia ferropriva possui alta incidência na gestação, com fatores de riscos classificados como idade (adolescência ou terceira idade), condição socioeconômica (baixa renda), baixa escolaridade, histórico pessoal e familiar antecedente, doenças crônicas, dieta pobre em ferro e outros. O acompanhamento médico periódico deve se valer da avaliação clínica e laboratorial para avaliar riscos e níveis de hemoglobina, de modo a intervir nos casos de anemia ferropriva gestacional, evitando os riscos para o binômio materno fetal, identificados como aborto, parto prematuro, má formação, problemas no Sistema Nervoso Central (SNC) e sistema cognitivo, complicações intra e pós-parto, dentre outros. CONCLUSÕES: Os cuidados médicos preventivos e corretivos devem considerar todos os fatores de risco, dispondo da realização periódica da anamnese clínica e dos exames laboratoriais, da suplementação por sulfato ferroso e da adequação nutricional.

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Iron Deficiency Anemia in Pregnancy after Bariatric Surgery: Etiology, Risk Factors, and How to Manage It

Cited by 3 publications

References 19 publications

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort

Iron Treatment in Patients with Iron Deficiency Before and After Metabolic and Bariatric Surgery: A Narrative Review

Anemia Ferropriva E Atipicidades Gestacionais: Cuidados Médicos Preventivos E Corretivos Necessários

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