Abstract
Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. 71 patients with a history of bariatric surgery, who had at least one pregnancy ended with a delivery of a single live-born neonate after the bariatric surgery were included in the study. The main endpoints were gestational weight gain (GWG), GWG as % of the maternal weight at the beginning of pregnancy (GWG%), maternal anemia, SGA and large for gestational age infants (LGA), neonatal intensive care unit admission (NICU). GWG% was 23.8% ± 14.1 in the LGA group vs 13.9% ± 11.0 in the normal weight neonates group; p < 0.03. Patients diagnosed with anemia before pregnancy had higher GWG% than patients without pre-pregnancy anemia (20.1% ± 11.1 vs 13.4% ± 11.6); p < 0.05. GWG% was higher in patients, whose infants were admitted to NICU (25.3% ± 17.6 vs 14.1% ± 11.0; p < 0.04). GWG% can be considered a risk predictor of the LGA and NICU admissions in bariatric patients. Anemia diagnosed before pregnancy is associated with higher GWG%.
Highlights
Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. 71 patients with a history of bariatric surgery, who had at least one pregnancy ended with a delivery of a single live-born neonate after the bariatric surgery were included in the study
Abbreviations gestational diabetes mellitus (GDM) Gestational diabetes mellitus PIH Pregnancy induced hypertension cesarean section (CS) Cesarean section SGA Small for gestational age infants CHLO Polish Association of Bariatric Patients laparoscopic sleeve gastrectomy (LSG) Laparoscopic sleeve gastrectomy laparoscopic Roux-en-Y gastric banding (LRYGB) Laparoscopic Roux-en-Y gastric banding adjustable silicone gastric banding (ASGB) Adjustable silicone gastric banding gestational weight gain (GWG) Gestational weight gain large for gestational age infants (LGA) Large for gestational age infants oral glucose tolerance test (OGTT) Oral glucose tolerance test body mass index (BMI) Body mass index EWL% Excess weight loss pre-pregnancy hypertension (PPH) Pre-pregnancy hypertension PGDM Pre-pregnancy diabetes mellitus restrictive surgery (RS) Restrictive surgery malabsorptive surgery (MS) Malabsorptive surgery GWG% Gestational weight gain presented as % of pre-pregnancy maternal weight CTG Cardiotocography neonatal intensive care unit admission (NICU) Neonatal intensive care unit time from surgery to conception (TTC) Time from surgery to conception IUGR Intrauterine growth restriction
GWG% seems to be a better predictor of adverse pregnancy and neonatal outcomes than GWG, as it presents more accurately the real proportion of maternal weight gain during pregnancy
Summary
Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. 71 patients with a history of bariatric surgery, who had at least one pregnancy ended with a delivery of a single live-born neonate after the bariatric surgery were included in the study. Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. It is estimated that more than 600 million people are obese worldwide It is associated with numerous co-morbidities, including diabetes mellitus, hypertension, obstructive sleep apnea and many others that influence the pregnancy course and neonatal outcomes. Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia; the risk of large for gestational age infants (LGA), PIH and GDM is reduced[13,14,15,16,17]. The main purpose of the study was to analyze the influence of gestational weight gain after bariatric surgery on pregnancy outcomes, the secondary aim was to investigate the possible utility of presenting the gestational weight gain as percentage of maternal weight before the pregnancy in bariatric patients
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