Bariatric Surgeries in Pregnancy—As Different as One May Think? [17R

Abstract

INTRODUCTION: Bariatric surgery pregnant patients are at risk for nutrient deficiencies. The objective is to identify specific nutritional deficiencies, monitor the degree of deficiency, the pre-pregnancy BMI, gestational weight gain, and pregnancy outcomes among different bariatric surgeries. METHODS: Over a three year period, bariatric pregnant patients were identified. Data included: type of bariatric surgery, interval between surgery and pregnancy, pre and last visit BMI, gestational weight gain, diagnosis of diabetes, nutritional deficiencies in the beginning and end of pregnancy, supplements, birthweight, and mode of delivery. Logistic regression analysis assessed associations between each type of bariatric surgery and above data points. RESULTS: 125 patients with a history of bariatric surgery were identified. 41% Roux-en-Y, 28% gastric sleeve, 8% gastric band, 2% biliopancreatic diversion, and 21% unsure of the type. Postpartum hemoglobin was significant (P=.006). All other nutrients did not differ significantly. Pre-pregnancy BMI's did not differ significantly but 100% of gastric band patients were obese, 66% of Roux-en-Y, and 52% of gastric sleeve. Women gained too much weight in all groups. The last visit BMI was significant among the groups (P=.04). As the years post surgery increases, so does the last visit weight (P=.03). At delivery, no difference was noted in primary cesarean rate or birth weight. CONCLUSION: No significant difference in nutrition among different bariatric surgeries exists. Supplementation is needed in each type and nutritional screening is essential. Most women remain obese and gain too much weight. Delivery risks are no different among the surgeries.