Micronutrient supplementation in pregnancies following bariatric surgery: a practical review for clinicians

Vanheule, Greet; Ceulemans, Dries; Vynckier, An-Katrien; Mulder, Paulien De; Driessche, M. Van Den; Devlieger, Roland

doi:10.1007/s11695-021-05546-z

Cited by 8 publications

(1 citation statement)

References 104 publications

(364 reference statements)

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“…Ein mögliches Schema der Supplementierung nach adipositaschirurgischen und metabolischen Operationen gibt folgende Tabelle, die sich an den Empfehlungen zweier Arbeiten und an der Leitlinie "Chirurgie der Adipositas und metabolischer Erkrankungen" orientiert (▶ Tab. 5) [25,26].…”

Section: Mögliches Schema Zur Supplementationunclassified

Schwangerenbetreuung nach bariatrischer und postbariatrischer Operation

Stumpfe¹,

Krautz²,

Beckmann³

et al. 2023

Frauenheilkunde up2date

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Section: Mögliches Schema Zur Supplementationunclassified

Schwangerenbetreuung nach bariatrischer und postbariatrischer Operation

Stumpfe¹,

Krautz²,

Beckmann³

et al. 2023

Frauenheilkunde up2date

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A systematic review on clinical practice guidelines for managing pregnancy following metabolic‐bariatric surgery

Moradi,

Kashanian,

Sheidaei

et al. 2024

Obesity

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ObjectiveThe ongoing pandemic of obesity is associated with an increase of weight loss surgeries in women of reproductive age. This study was conducted to review clinical practice guidelines (CPGs) for managing pregnancy following metabolic‐bariatric surgery.MethodsWe conducted a comprehensive literature search of all CPGs that covered the management of pregnancy following metabolic‐bariatric surgery, 2010 through 2022, and that were published in English. Two authors independently scored the quality and usefulness of CPGs using the Appraisal of Guidelines for Research and Evaluation II tool (AGREE II).ResultsFrom a total of 20 CPGs, consistent recommendations included the following: 1) contraception with long‐acting reversible contraceptives before surgery until the optimal time of pregnancy; 2) nutritional care by a dietitian; 3) considering gastrointestinal discomforts during pregnancy as a potential surgical complication; and 4) modified screening for gestational diabetes instead of glucose tolerance tests preventing post‐bariatric hypoglycemia. There was a lack of uniformity concerning surgery‐to‐conception interval and dose of supplements, as well as research gaps regarding the surgical type, mental health, delivery type, breastfeeding, neonatal care, and weight retention.ConclusionsAll recommendations for managing pregnancy after metabolic‐bariatric surgery were deemed clinically useful. Although consistent recommendations should be implemented, inconsistencies should be the focus of research.

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Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study

Heusschen,

Berendsen,

van Bon

et al. 2024

OBES SURG

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Introduction Pregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized “weight loss surgery” multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS. Methods Multicenter observational cohort study including 119 pregnant women at 41.0 (18.5–70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users. Results During pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users. Conclusion Low maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population. Graphical Abstract

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Micronutrient supplementation in pregnancies following bariatric surgery: a practical review for clinicians

Cited by 8 publications

References 104 publications

Schwangerenbetreuung nach bariatrischer und postbariatrischer Operation

Schwangerenbetreuung nach bariatrischer und postbariatrischer Operation

A systematic review on clinical practice guidelines for managing pregnancy following metabolic‐bariatric surgery

Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study

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