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

Abstract

AIM

We aimed to evaluate the impact of bariatric surgery (BS) on maternal and fetal outcomes.

METHODS

A retrospective, descriptive, observational study of 39 pregnant women who underwent BS in our institution between 2010 and 2014 was carried out. A sample of women who became pregnant after BS was evaluated, based on data concerning pregnancy, childbirth, and newborns.

RESULTS

Of the 1182 patients who underwent BS at our institution during the study period, 1016 (85.9%) were women. Thirty-nine of these women (with an average age of 31 ± 4.8 years) became pregnant (one twin pregnancy) and 29 of the 39 had undergone a gastric bypass. The mean time interval between BS and pregnancy was 16.6 ± 4.8 months; however, 16 (41%) women became pregnant less than a year after BS. The pre-BS body mass index (BMI) of the 39 women was 44.5 ± 6.2 kg/m2 . The women had a mean BMI of 30.2 ± 3.8 kg/m2 when they got pregnant and they gained 13.2 ± 7.3 kg during pregnancy. Iron deficiency was observed in 18 (46.1%) women, 16 (45.7%) had vitamin B12 deficiency, 12 (66.8%) had zinc deficiency, and 20 (60.6%) had vitamin D deficiency. Three women developed gestational diabetes mellitus. Premature rupture of membranes occurred in two pregnancies, preterm delivery in five, and there was one spontaneous abortion. Cesarean section was performed in seven cases. The average newborn weight was 3002 ± 587 g, five were small for gestational age, and one had macrosomia. Three infants had to be admitted to an intensive care unit.

CONCLUSION

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.

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  • Authors+Show Affiliations

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    ,

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal.

    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar de São João E.P.E, Porto, Portugal. Faculty of Medicine, University of Porto, Porto, Portugal. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

    Source

    MeSH

    Adult
    Bariatric Surgery
    Diabetes, Gestational
    Female
    Humans
    Infant, Newborn
    Infant, Newborn, Diseases
    Male
    Obesity, Morbid
    Pregnancy
    Pregnancy Complications
    Pregnancy Outcome
    Retrospective Studies
    Vitamin B 12 Deficiency
    Vitamin D Deficiency
    Young Adult
    Zinc

    Pub Type(s)

    Journal Article
    Observational Study

    Language

    eng

    PubMed ID

    29349843

    Citation

    Costa, Maria Manuel, et al. "Pregnancy After Bariatric Surgery: Maternal and Fetal Outcomes of 39 Pregnancies and a Literature Review." The Journal of Obstetrics and Gynaecology Research, vol. 44, no. 4, 2018, pp. 681-690.
    Costa MM, Belo S, Souteiro P, et al. Pregnancy after bariatric surgery: Maternal and fetal outcomes of 39 pregnancies and a literature review. J Obstet Gynaecol Res. 2018;44(4):681-690.
    Costa, M. M., Belo, S., Souteiro, P., Neves, J. S., Magalhães, D., Silva, R. B., ... Carvalho, D. (2018). Pregnancy after bariatric surgery: Maternal and fetal outcomes of 39 pregnancies and a literature review. The Journal of Obstetrics and Gynaecology Research, 44(4), pp. 681-690. doi:10.1111/jog.13574.
    Costa MM, et al. Pregnancy After Bariatric Surgery: Maternal and Fetal Outcomes of 39 Pregnancies and a Literature Review. J Obstet Gynaecol Res. 2018;44(4):681-690. PubMed PMID: 29349843.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pregnancy after bariatric surgery: Maternal and fetal outcomes of 39 pregnancies and a literature review. AU - Costa,Maria Manuel, AU - Belo,Sandra, AU - Souteiro,Pedro, AU - Neves,João S, AU - Magalhães,Daniela, AU - Silva,Rita B, AU - Oliveira,Sofia C, AU - Freitas,Paula, AU - Varela,Ana, AU - Queirós,Joana, AU - Carvalho,Davide, Y1 - 2018/01/18/ PY - 2017/05/17/received PY - 2017/11/29/accepted PY - 2018/1/20/pubmed PY - 2018/10/23/medline PY - 2018/1/20/entrez KW - endocrine KW - nutrition KW - obesity KW - obstetrics KW - surgery SP - 681 EP - 690 JF - The journal of obstetrics and gynaecology research JO - J. Obstet. Gynaecol. Res. VL - 44 IS - 4 N2 - AIM: We aimed to evaluate the impact of bariatric surgery (BS) on maternal and fetal outcomes. METHODS: A retrospective, descriptive, observational study of 39 pregnant women who underwent BS in our institution between 2010 and 2014 was carried out. A sample of women who became pregnant after BS was evaluated, based on data concerning pregnancy, childbirth, and newborns. RESULTS: Of the 1182 patients who underwent BS at our institution during the study period, 1016 (85.9%) were women. Thirty-nine of these women (with an average age of 31 ± 4.8 years) became pregnant (one twin pregnancy) and 29 of the 39 had undergone a gastric bypass. The mean time interval between BS and pregnancy was 16.6 ± 4.8 months; however, 16 (41%) women became pregnant less than a year after BS. The pre-BS body mass index (BMI) of the 39 women was 44.5 ± 6.2 kg/m2 . The women had a mean BMI of 30.2 ± 3.8 kg/m2 when they got pregnant and they gained 13.2 ± 7.3 kg during pregnancy. Iron deficiency was observed in 18 (46.1%) women, 16 (45.7%) had vitamin B12 deficiency, 12 (66.8%) had zinc deficiency, and 20 (60.6%) had vitamin D deficiency. Three women developed gestational diabetes mellitus. Premature rupture of membranes occurred in two pregnancies, preterm delivery in five, and there was one spontaneous abortion. Cesarean section was performed in seven cases. The average newborn weight was 3002 ± 587 g, five were small for gestational age, and one had macrosomia. Three infants had to be admitted to an intensive care unit. CONCLUSION: 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. SN - 1447-0756 UR - https://www.unboundmedicine.com/medline/citation/29349843/Pregnancy_after_bariatric_surgery:_Maternal_and_fetal_outcomes_of_39_pregnancies_and_a_literature_review_ L2 - https://doi.org/10.1111/jog.13574 DB - PRIME DP - Unbound Medicine ER -