Timing of Gestation After Laparoscopic Sleeve Gastrectomy (LSG): Does It Influence Obstetrical and Neonatal Outcomes of Pregnancies?

Sancak, Seda; Çeler, Özgen; Çırak, Elif; Karip, Aziz Bora; Aydın, Mustafa; Bulut, Nuriye Esen; Fersahoğlu, Mehmet Mahir; Altun, Hasan; Memışoğlu, Kemal

doi:10.1007/s11695-018-03700-8

Cited by 19 publications

(13 citation statements)

References 50 publications

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“…Previous studies found no associations between the time from surgery to conception and adverse pregnancy or neonatal outcomes [4,[15][16][17][18][19][20][21][22][23][24]. In fact, most studies confirm that the risk of these outcomes is not increased during the first 12 months after bariatric surgery compared to later pregnancies [4,16,17,19,22,25].…”

Section: Discussionmentioning

confidence: 98%

A Matter of Timing—Pregnancy After Bariatric Surgery

et al. 2021

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Purpose Current guidelines recommend to avoid pregnancy for 12–24 months after bariatric surgery because of active weight loss and an increased risk of nutritional deficiencies. However, high-quality evidence is lacking, and only a few studies included data on gestational weight gain. We therefore evaluated pregnancy and neonatal outcomes by both surgery-to-conception interval and gestational weight gain. Materials and Methods A multicenter retrospective analysis of 196 singleton pregnancies following Roux-en-Y gastric bypass, sleeve gastrectomy, and one anastomosis gastric bypass was conducted. Pregnancies were divided into the early group (≤ 12 months), the middle group (12–24 months), and the late group (> 24 months) according to the surgery-to-conception interval. Gestational weight gain was classified as inadequate, adequate, or excessive according to the National Academy of Medicine recommendations. Results Pregnancy in the early group (23.5%) was associated with lower gestational age at delivery (267.1 ± 19.9 days vs 272.7 ± 9.2 and 273.1 ± 13.5 days, P = 0.029), lower gestational weight gain (− 0.9 ± 11.0 kg vs + 10.2 ± 5.6 and + 10.0 ± 6.4 kg, P < 0.001), and lower neonatal birth weight (2979 ± 470 g vs 3161 ± 481 and 3211 ± 465 g, P = 0.008) than pregnancy in the middle and late group. Inadequate gestational weight gain (40.6%) was associated with lower gestational age at delivery (266.5 ± 20.2 days vs 273.8 ± 8.4 days, P = 0.002) and lower neonatal birth weight (3061 ± 511 g vs 3217 ± 479 g, P = 0.053) compared to adequate weight gain. Preterm births were also more frequently observed in this group (15.9% vs 6.0%, P = 0.037). Conclusion Our findings support the recommendation to avoid pregnancy for 12 months after bariatric surgery. Specific attention is needed on achieving adequate gestational weight gain.

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Section: Discussionmentioning

confidence: 98%

A Matter of Timing—Pregnancy After Bariatric Surgery

et al. 2021

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“…showed an increased risk of SGA infants for patients who had a pregnancy within 18 months after LSG when compared with patients who had pregnancy after more than 18 months. However, Sancak et al . reported no difference between the groups before 18 months versus after 18 months regarding the rate of SGA babies.…”

Section: Discussionmentioning

confidence: 97%

“…reported decreased C/S rates in patients who had undergone bariatric surgery than obese controls. Sancak et al . compared the obstetric outcomes of patients after LSG before 18 months and later than 18 months and they found no difference in C/S rates between the groups.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies did not recommend pregnancy for at least 12 months after bariatric surgery . However, there is no evidence that shows increased adverse obstetric outcomes during the first year after surgery . Furthermore, most previous studies included different time intervals between pregnancy and surgery along with utilization of different surgical methods.…”

Section: Introductionmentioning

confidence: 99%

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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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“…However, a French study of pregnancy outcomes among 56 women who underwent RYGB found no relation between the timing of surgery and conception with the outcomes, which might be due to the higher mean time from surgery to pregnancy (32 ± 14 months) [11]. Likewise, no significant difference was found between the two study groups who became pregnant ≤ 18 months and > 18 months regarding preterm labor, birth weight, and SGA or LGA [51].…”

Section: Surgery-to-conception Intervalmentioning

confidence: 98%

Maternal Nutritional Status and Pregnancy Outcomes Post-bariatric Surgery

Alamri

Abdeen

2022

OBES SURG

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Obesity in childbearing women leads to pregnancy-related complications such as gestational diabetes mellitus, pregnancy-associated hypertensive disorders, and macrosomia. Weight loss helps reduce these complications. Studies show bariatric surgery reduces obesity-related complications during and after pregnancy. However, bariatric surgery might be associated with adverse outcomes, such as low birth weight and small-for-gestational-age infants. In addition, several studies suggest pregnancy occurring less than a year post-bariatric surgery adversely affects pregnancy outcomes and causes micronutrients deficiency since the dramatic weight loss occurs in the first year. These adverse outcomes may lead to nutritional malabsorption, such as anemia and low vitamin B12 and folic acid levels. The review aims to overview obesity-related complications during pregnancy and the benefits and risks of bariatric surgery on pregnancy outcomes and maternal nutrition status. Graphical abstract

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Timing of Gestation After Laparoscopic Sleeve Gastrectomy (LSG): Does It Influence Obstetrical and Neonatal Outcomes of Pregnancies?

Cited by 19 publications

References 50 publications

A Matter of Timing—Pregnancy After Bariatric Surgery

A Matter of Timing—Pregnancy After Bariatric Surgery

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

Maternal Nutritional Status and Pregnancy Outcomes Post-bariatric Surgery

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