Pregnancy after bariatric surgery: <scp>M</scp>aternal and fetal outcomes of 39 pregnancies and a literature review

Costa, Marlene; Belo, Sandra; Souteiro, Pedro; Neves, João Sérgio; Magalhães, Diogo; Silva, Rita B.; Oliveira, Sofia Castro; Freitas, Paula; Varela, Ana; Queirós, Joana; Carvalho, Davide

doi:10.1111/jog.13574

Cited by 33 publications

(27 citation statements)

References 42 publications

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“…Obese women of reproductive age can suffer from infertility due to hormonally related ovulation dysfunction. Obesity in pregnant women increases the incidence of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), which also influences the way of delivery, with an increase in number of vacuum deliveries and cesarean sections [2,3]. Bariatric surgery is the reference method of treatment for obesity, because of the durability and pace of the weight loss, reduction of symptoms and remission of concomitant diseases.…”

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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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: 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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“…The previous few decades have seen an increase in the number of bariatric surgeries being performed since it is the treatment of choice for severe obesity and results in sustained weight loss . Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical technique and recently has been applied more and preferred over other bariatric surgical methods because of its safety, simplicity and effectiveness with regard to sustained weight loss over time …”

Section: Introductionmentioning

confidence: 99%

Effects of laparoscopic sleeve gastrectomy on obstetric outcomes within 12 months after surgery

Karadağ

Demircan

Çalışkan

2019

J of Obstet and Gynaecol

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Aim: To determine the obstetric and neonatal outcomes of pregnant patients having undergone laparoscopic sleeve gastrectomy (LSG) in the previous 12 months. Methods: This retrospective and observational study included 144 pregnant women: 48 had pregnancies within 12 months after LSG (Group A), 42 became pregnant more than 1 year after surgery (Group B) and 54 obese pregnant women who had a body mass index (BMI) >30 kg/m 2 , were categorized as the control group because they did not undergo surgery (Group C). The participants' early gestational BMI, predelivery BMI and gestational weight gain were determined and the obstetric and neonatal outcomes of the groups were compared. Results: The time interval from surgery to conception was 7.8 AE 3.4 months and 25.8 AE 13.4 months for Groups A and B, respectively (P < 0.01). There were no significant differences in the rates of gestational hypertension, pre-eclampsia, preterm delivery and cesarean section between the groups. The number of patients with gestational diabetes mellitus was significantly higher in Group C than in Groups A and B (P = 0.004). The number of large-for-gestational-age infants was higher in Group C than in Groups A and B (P = 0.046). The number of small-for-gestational-age infants was significantly higher in Group A than in Groups B and C (P = 0.025). Conclusion: Pregnancy within one year after LSG is related to an increased risk of small-for-gestational-age infants. LSG decreases the risk of gestational diabetes mellitus independent of the time interval between surgery and conception.

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“…Furthermore, women who are obese are more likely to have children who are obese ( Oestreich & Moley, 2017 ), perpetuating health problems from generation to generation. There is evidence that obese individuals are deficient in micronutrients ( Costa et al, 2018 ; Krzizek et al, 2018 ; Stankowiak-Kulpa et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Dietary diversity is inversely correlated with pre-pregnancy body mass index among women in a Michigan pregnancy cohort

Kornatowski

Comstock

2018

PeerJ

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BackgroundDuring pregnancy, healthy maternal body weight and a nutritionally complete diet provide a favorable environment for fetal development. Yet nearly two-thirds of women of reproductive age in the United States (US) are either overweight or obese. The objective of this research was to investigate the relationship between a measure of dietary diversity and body mass index (BMI) in a sample of women enrolled in a US pregnancy cohort.MethodsDietary data was obtained from one 24-hour dietary recall collected during the third trimester of pregnancy (n = 40). Pre-pregnancy BMI was calculated from pre-pregnancy weight and height self-reported by survey at the time of enrollment. Using the Minimum Dietary Diversity for Women (MDD-W) indicator developed by the Food and Agriculture Organization of the United Nations, dietary data was categorized and scored.ResultsOverall, 35% of participants did not achieve minimum dietary diversity (MDD-W ≥5). In addition, 45% of participants were obese, 35% were normal weight and 20% were overweight. Women with higher BMI had lower MDD-W scores than women with lower BMI (p < 0.05). The median MDD-W for both normal and overweight women was ≥5 indicating that normal and overweight pregnant women tended to consume a diet that was high in micronutrients. Conversely, the median MDD-W for obese women was below 5 meaning these women tended to consume a diet that was low in micronutrient density. The most commonly consumed food group was grain. In addition, 75% of all participants consumed sweetened drinks. Individuals with an MDD-W score ≥5, were more likely to have consumed dark green leafy vegetables, vitamin A-rich fruits or vegetables, other vegetables and other fruits than those with MDD-W scores <5.DiscussionIn this study, we show that a food group diversity indicator that has been shown to reflect adequacy of micronutrient intake in populations from less economically developed countries may also be informative in US populations. Furthermore, these results reflect the importance of encouraging all pregnant women with less varied diets to consume more fruits and vegetables.

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Pregnancy after bariatric surgery: Maternal and fetal outcomes of 39 pregnancies and a literature review

Abstract: Although pregnancy after BS is safe and well tolerated, close monitoring by a multidisciplinary team is required to evaluate complications resulting from BS, especially a deficit of micronutrients.

Cited by 33 publications

References 42 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

Effects of laparoscopic sleeve gastrectomy on obstetric outcomes within 12 months after surgery

Dietary diversity is inversely correlated with pre-pregnancy body mass index among women in a Michigan pregnancy cohort

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