A Matter of Timing-Pregnancy After Bariatric Surgery.

Tytuł:: A Matter of Timing-Pregnancy After Bariatric Surgery.
Autorzy:: Heusschen L; Department of Bariatric Surgery, Vitalys, part of Rijnstate hospital, Postal number 1191, PO box 9555, 6800TA, Arnhem, The Netherlands. .; Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands. .
Krabbendam I; Department of Obstetrics and Gynecology, Hospital Gelderse Vallei, Ede, The Netherlands.
van der Velde JM; Department of Obstetrics and Gynecology, Hospital Gelderse Vallei, Ede, The Netherlands.
Deden LN; Department of Bariatric Surgery, Vitalys, part of Rijnstate hospital, Postal number 1191, PO box 9555, 6800TA, Arnhem, The Netherlands.
Aarts EO; Department of Bariatric Surgery, Vitalys, part of Rijnstate hospital, Postal number 1191, PO box 9555, 6800TA, Arnhem, The Netherlands.
Merién AER; Department of Obstetrics and Gynecology, Rijnstate hospital, Arnhem, The Netherlands.
Emous M; Center of Obesity the Northern Netherlands, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Bleumink GS; Department of Internal Medicine, Rijnstate hospital, Arnhem, The Netherlands.
Lutgers HL; Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Hazebroek EJ; Department of Bariatric Surgery, Vitalys, part of Rijnstate hospital, Postal number 1191, PO box 9555, 6800TA, Arnhem, The Netherlands.; Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.
Źródło:: Obesity surgery [Obes Surg] 2021 May; Vol. 31 (5), pp. 2072-2079. Date of Electronic Publication: 2021 Jan 11.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: 2006- : New York : Springer Science + Business Media
Original Publication: Oxford, OX, UK : Rapid Communications of Oxford, [1991-
MeSH Terms:: Bariatric Surgery*
Gastric Bypass*/adverse effects
Obesity, Morbid*/surgery
Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies
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Contributed Indexing:: Keywords: Gestational weight gain; IOM; NAM; Neonatal outcomes; One anastomosis gastric bypass; Roux-en-Y gastric bypass; Sleeve gastrectomy; Surgery-to-conception time interval
Entry Date(s):: Date Created: 20210112 Date Completed: 20210419 Latest Revision: 20210731
Update Code:: 20240105
PubMed Central ID:: PMC8041698
DOI:: 10.1007/s11695-020-05219-3
PMID:: 33432482
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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.

Comment in: Obes Surg. 2021 Jun;31(6):2795-2796. (PMID: 33624211)
Comment in: Obes Surg. 2021 Jun;31(6):2793-2794. (PMID: 33625655)

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