Pregnancy outcome of patients who conceive after bariatric surgery

The aim of the study was to determine the outcomes of pregnancy in the reproductive period among patients with previous surgery due to obesity. 14 women who had a live birth after bariatric surgery enrolled in this study. The primary targets were gestational age and birth weights. The median duration of pregnancy was 270 days (minimum 256, maximum 281 days), with 2 patients giving birth from 36-37 weeks gestation. The mean birth weight was 3017 ± 285 g (minimum 2390, maximum 3380 g), with 2 patients having birth weight below 2500 g. The result of this study suggests that patients who undergo bariatric surgery have acceptable obstetric outcome.

PDF

___

1. Haslam DW, James WPT. Obesity. Lancet .2005;366:1197-209.

2. Obesity and overweight. http://www.who.int/news-room/fact-sheets/detail/obesityand-Overweight access date 5.09.2018

3. Statistics related to overweight and obesity. http://www.win.niddk.nih.gov/statistics/index.htm access date 2007

4. Institute of medicine. Nutrition During Pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements.Washington, DC: The National Academy of Sciences, 1990

5. Kim SY, Dietz PM, England L, et al. Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity (Silver Spring). 2007;15:986-93.

6. Sebire NJ, Jolly M, Harris JP, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25:1175-82.

7. Shah A, Sands J, L Kenny. Maternal obesity and the risk of still birth and neonatal death. J Obstet Gynaecol. 2006;26 (Suppl 1):19-25.

8. Wang JX, Davies MJ, Norman RJ. Obesity increases the risk of spontaneous abortion during infertility treatment. Obesity Res. 2002;10:551-4.

9. Vesco KK, Dietz PM, Rizzo J, et al. Excessive gestational weight gain and postpartum weight retention among obese women. Obstet Gynecol. 2009;114:1069-75.

10. Grossetti E, Beucher G, Regeasse A, et al. Obstetrical complications of morbid obesity. Gynecol Obstet Biol Reprod. 2004;33:739-44.

11. Kristensen J, Vestergaard M, Wisborg K, et al. Pre pregnancy weight and the risk of still birth and neonatal death. BJOG. 2005;112:403-8.

12. Weiss JL, Malone FD, Emig D, et al. Obesity , obstetric complications, and cesarean delivery rate-a population based screening study. FASTER Research Consortium. Am J Obstet Gynecol. 2009;114:1069-75.

13. CEMACH 2000–2002. Why mothers die. The sixth report of the confidential enquiries into maternal deaths in the United Kingdom. Regents Park, London: RCOG Press, 2004.

14. Mhyre JM. Anesthetic management for the morbidly obese pregnant woman. Int Anesthesiol Clin. 2007;45:51-70.

15. Myles TD, Gooch J,Santolaya J. Obesity as an independent risk factors for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol. 2002;100:959-964.

16. American Collage of Obstetricians and Gynecologist Bariatric surgery and pregnancy. ACOG Practice Bulletin No.105. Obstet Gynecol. 2009;113:1405-13.

17. Buchwald H,Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.

18. Eerdekens A, Debeer A, Van Hoey G, et al. Maternal bariatric surgery: adverse outcomes in neonates. Eur J Pediatr. 2010;169:191-6.

19. American College of Obstetricians and Gynecologists. Diagnosis and management of preeclampsia and eclampsia. ACOG Practice Bulletin No. 33. Obstet Gynecol. 2002;99:159-67.

20. Association AD. 2. Classification and Diagnosis of Diabetes: Standards of medical Care in Diabetes—2018. Diabetes Care. 2018;41(Supplement 1):13-27.

21. Colquitt JL, Clegg AJ, Loveman E, et al. Surgery for morbid obesity. Cochrane Database of Systematic Reviews 2005;4:CD003641.

22. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery. JAMA. 2008;300:2286-96.

23. Davis MM, Slish K, Chao C, Cabana MD. National trends in bariatric surgery, 1996-2002. Arch Surg. 2006;141:71-4.

24. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724-37.

25. Burke AE, Bennett WL, Jamshidi RM, et al. Reduced incidence of gestational diabetes with bariatric surgery. J Am Coll Surg. 2010;211:169-75.

26. Kjaer MM, Lauenborg J, Breum BM, Nilas L. The risk of adverse pregnancy outcome after baritric surgery:a nationwide register-based matched cohort study. Am J Obstet Gynecol. 2013;208:464-7.

27. Bennett WL, Gilson MM, Jamshidi R, et al. Impact of bariatric surgery on hypertensive disorders in pregnancy: retrospective analysis of insurance claims data. BMJ. 2010;340:c1662.

28. Richards DS, Miller DK, Goodman GN. Pregnancy after gastric bypass for morbid obesity. J Reprod Med. 1987;32:172-6.

29. Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol. 2005;106:965-72.

30. Sheiner E, Levy A, Silverberg D, et al. Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Am J Obstet Gynecol. 2004;190:1335–40.

31. Winetraub AY, Levy A, Levi I, Mazor M, Wiznitzer A, Sheiner E. Effect of bariatric surgery on pregnancy outcome. Int J Gynecol Obstet. 2008;103:246–51.

32. Dixon JB, Dixon ME, O’Brien PE. Pregnancy after Lap Band surgery: management of the band to achieve healthy weight outcomes. Obes Surg. 2001;11:59-65.

33. Patel JA, Patel NA, Thomas RL, et al. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4:39-45.

34. Stephanson O, Johansson K, Söderling J, et al. Delivery outcomes in term births after bariatric surgery: Population based matched cohort study. PLos Med. 2018;26:175-80.

35. Ramirez MM, Turrentine MA. Gastrointestinal haemorrhage during pregnancy in a patient with a history of vertical- banded gastroplasty. Am J Obstet Gynecol. 1995;173:1630-1.

36. Wax JR, Wolff R, Cobean R, et al. Intussusception complicating pregnancy following laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17:977–9.

37. Moore KA, Ouyang DW, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. N Engl J Med. 2004;351:721–2.

38. Benjamin RH, Littlejohn S, Mitchell LE. Bariatric surgery and birth defects: a systematic literature review. Paediatr Perinat Epidemiol. 2018;32:533-44.

39. Josefsson A, Blomberg M, Bladh M, Frederiksen SG, Sydsjo G. Bariatric surgery in a national cohort of women: sociodemographic and obstetric outcomes. Am J Obstet Gynecol. 2011; 205:206.e1-8.

40. Belogolovkin V, Salihu HM, Weldeselasse H, et al. Impact of prior bariatric surgery on maternal and fetal outcomes among obese and non-obese mothers. Arch Gynecol Obstet. 2012;285:1211-8.

41. Patel JA, Patel NA, Thomas RL, et al. Pregnancy outcomes after laparoscopic Roux-en-y gastric bypass. Surg ObesRelat Dis. 2008;4:39-45.

42. Rottenstreich A, Levin G, Kleinstern G, et al. The effect of surgery to conception interval on pregnancy outcomes after sleeve gastrectomy. Surgery Obes Rel Dis. 2018;14:1795-803.

43. ACOG Practice Bulletine. Bariatric surgery and pregnancy. Obstet Gynecol. 2009;105:1405-13.