Supplementation Adherence and Outcomes Among Pregnant Women After Bariatric Surgery

Faria, Sílvia Leite; Faria, Orlando Pereira; Gouvêa, Heloisa Rodrigues de; Amato, Angélica Amorim

doi:10.1007/s11695-018-3499-y

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…In fact, the increase in PTD is an unexpected consequence considering that obesity is a risk factor for PTD. Macro and micronutrient deficiencies (e.g., vitamins A, B and D, calcium, iron) after BS procedures, especially if not adequately supplemented during pregnancy, probably play a crucial role, as they have been considered risk factors for several fetal complications, such as PTD, LBW, SGA, hypotonia, mental retardation, neural tube defects, microcephaly, IUGR, and intracranial hemorrhages [17]. BS may impact on the pregnancy-related blood metabolites and metabolic pathways, whose concentrations change as pregnancy progresses.…”

Section: Discussionmentioning

confidence: 99%

“…Although the number of pregnancies after BS has rapidly increased over the past years and several population-based studies have assessed the impact of BS on perinatal outcomes, the findings of these studies remain controversial [10][11][12][13][14][15]. Recent studies suggested that BS in women with severe obesity may improve both fertility and perinatal outcomes and, specifically, reduce the risks for GDM, preeclampsia, and macrosomia, compared with pregnant obese women who have not undergone BS [16][17][18][19][20][21]. However, dealing with pregnant women who underwent BS poses a crucial clinical challenge and several questions need to be addressed about the impact of BS on other adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy and post-partum outcomes of obese women after bariatric surgery: A case-control study

Savastano¹,

Caruso²,

Pompeo

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pregnancy and post-partum outcomes of obese women after bariatric surgery: A case-control study

Savastano¹,

Caruso²,

Pompeo

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…This will allow associations to be drawn with clinical outcomes in the offspring and provide evidence-based dietary advice. Further investigation of food group intake and analysis of dietary patterns is also warranted, in order to emphasise and optimise nutritional intake from food as much as possible, especially considering that adherence to micronutrient supplementation is poor [59]. The AURORA (bAriatric sURgery in women Of Reproductive Age) study, a prospective cohort study in Belgium, is an example of such a study that can provide data [41,60]; however, other similar studies internationally are also needed.…”

Section: Discussionmentioning

confidence: 99%

What Is Known About the Nutritional Intake of Women during Pregnancy Following Bariatric Surgery? A Scoping Review

et al. 2019

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Optimising the diet and weight of women prior to and during pregnancy is of paramount importance to both maternal and offspring health. In women who become pregnant after bariatric surgery, evidence suggests a better overall obstetric outcome in comparison to women with severe obesity managed conservatively. Historically, most studies in this population group have monitored supplement adherence or serum concentrations of micronutrients, rather than dietary intake. The aim of this study was to synthesise current knowledge of the dietary intake of women during pregnancy following bariatric surgery. A systematic search of search engines was conducted using the following databases: MEDLINE, Embase, CINAHL, Cochrane database, Scopus, Trip, NHS Evidence, UK Clinical Trials, ClinicalTrials.gov, Prospero, Epistemonikos and Open Grey. Titles and abstracts were screened independently by two reviewers against predefined inclusion and exclusion criteria. After removal of duplicates, 1594 titles were identified, of which 1586 were initially excluded. Following full-text review, four articles were included. In total, across all four studies, data from only 202 bariatric surgery participants were included, the majority of whom had had one type of surgery. Just one study included a control group. Reporting of nutritional outcomes was heterogenous, with none of the studies including complete macro and micronutrient intake results in their articles. An insufficient intake of protein was noted as a concern in two studies and associated with poor fetal growth in one study. Overall, this review has identified a paucity of data about the dietary intake of women during pregnancy after bariatric surgery.

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“…As a result, the prescribed vitamin supplements could either be not fully absorbed or the adherence to these supplements could be lower. Previous research shows that adherence to supplements is only 30% at 6 months after BS and decreases over time, and another study found that only 34.7% of post-bariatric pregnant women adhered to supplementation [28,29]. Hazart et al showed that counseling on vitamin supplementation increased adherence from 23.5% after surgery to 77.8-100% during pregnancy [9].…”

Section: Multivitamin Supplementation Adherencementioning

confidence: 99%

The Impact of Preconception Gastric Bypass Surgery on Maternal Micronutrient Status before and during Pregnancy: A Retrospective Cohort Study in the Netherlands between 2009 and 2019

et al. 2022

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Post-bariatric weight loss can cause iatrogenic malnutrition and micronutrient depletion. In this study, we evaluated the impact of gastric bypass surgery (GB) and multivitamin supplement use on maternal micronutrient status before and across pregnancy. A retrospective medical chart review of 197 singleton pregnancies after GB with a due date between 2009 and 2019 was performed at a bariatric expertise center in the Netherlands. Hemoglobin, calcium, iron status, folate, vitamin D, vitamin B12 and ferritin levels were determined before and after GB during standard follow-up and at all gestational trimesters and analyzed using linear mixed models. Patients were prescribed standard multivitamin supplements or multivitamins specifically developed for post-bariatric patients (FitForMe WLS Forte (FFM)). Overall, hemoglobin and calcium levels decreased after surgery and during pregnancy, whereas folate, vitamin D, and vitamin B12 levels increased, and iron levels remained stable. FFM use was associated with higher hemoglobin, folate, vitamin D, and ferritin levels. In conclusion, through adequate supplementation and follow-up, GB does not have to result in impaired micronutrient status. Supplements developed specifically for post-bariatric patients generally result in higher micronutrient values than regular multivitamins before and during pregnancy. These data emphasize the urgent need for nutritional counseling including dietary and multivitamin supplement advise for post-bariatric women contemplating and during pregnancy.

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Supplementation Adherence and Outcomes Among Pregnant Women After Bariatric Surgery

Abstract: Our data indicate satisfactory adherence to post-op micronutrient supplementation and few gestational complications following BS. Moreover, child's birth weight was not associated with maximum %WL, %WL at conception, or time since BS.

Cited by 9 publications

References 28 publications

Pregnancy and post-partum outcomes of obese women after bariatric surgery: A case-control study

Pregnancy and post-partum outcomes of obese women after bariatric surgery: A case-control study

What Is Known About the Nutritional Intake of Women during Pregnancy Following Bariatric Surgery? A Scoping Review

The Impact of Preconception Gastric Bypass Surgery on Maternal Micronutrient Status before and during Pregnancy: A Retrospective Cohort Study in the Netherlands between 2009 and 2019

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