What Is Known About the Nutritional Intake of Women during Pregnancy Following Bariatric Surgery? A Scoping Review.

Kate Maslin,Anne Brown,Jill Shawe,Annick Bogaerts,Alison James

doi:10.3390/nu11092116

Abstract

Optimising the diet and weight of women prior to and during pregnancy is of paramount importance to both maternal and offspring health. In women who become pregnant after bariatric surgery, evidence suggests a better overall obstetric outcome in comparison to women with severe obesity managed conservatively. Historically, most studies in this population group have monitored supplement adherence or serum concentrations of micronutrients, rather than dietary intake. The aim of this study was to synthesise current knowledge of the dietary intake of women during pregnancy following bariatric surgery. A systematic search of search engines was conducted using the following databases: MEDLINE, Embase, CINAHL, Cochrane database, Scopus, Trip, NHS Evidence, UK Clinical Trials, ClinicalTrials.gov, Prospero, Epistemonikos and Open Grey. Titles and abstracts were screened independently by two reviewers against predefined inclusion and exclusion criteria. After removal of duplicates, 1594 titles were identified, of which 1586 were initially excluded. Following full-text review, four articles were included. In total, across all four studies, data from only 202 bariatric surgery participants were included, the majority of whom had had one type of surgery. Just one study included a control group. Reporting of nutritional outcomes was heterogenous, with none of the studies including complete macro and micronutrient intake results in their articles. An insufficient intake of protein was noted as a concern in two studies and associated with poor fetal growth in one study. Overall, this review has identified a paucity of data about the dietary intake of women during pregnancy after bariatric surgery.

Highlights

Optimising the diet and weight of women prior to and during pregnancy is of paramount importance to both maternal and offspring health [1]
This review has identified a paucity of data about the dietary intake of women during pregnancy after bariatric surgery
The evidence underlying the importance of nutritional intake and being a healthy weight before and during pregnancy is substantial [1,3,4]

Summary

Introduction

Optimising the diet and weight of women prior to and during pregnancy is of paramount importance to both maternal and offspring health [1]. Obesity in women has been linked to a number of adverse reproductive and birth outcomes [2,3,4]. The prevalence and severity of obesity in women of reproductive age is increasing in many regions of the world [5,6,7,8]. Bariatric surgery is a viable treatment option for people with severe obesity that can result in significant and sustained weight loss [9,10]. In the United States (US), the number of bariatric surgeries taking place has increased considerably from. A similar trend is evident in the United Kingdom (UK,) where the number of surgeries has increased thirty-fold since 2000 [13], with half occurring in women of childbearing age [14]. Research suggests that future pregnancy is Nutrients 2019, 11, 2116; doi:10.3390/nu11092116 www.mdpi.com/journal/nutrients

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