The Impact of Pregnancy on Outcomes After Bariatric Surgery
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ORIGINAL CONTRIBUTIONS
The Impact of Pregnancy on Outcomes After Bariatric Surgery A. Brönnimann 1 & M. K. Jung 2 & N. Niclauss 2 & M. E. Hagen 2 & C. Toso 2 & Nicolas C. Buchs 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Bariatric surgery is performed mostly on obese women of reproductive age. Many studies have analyzed pregnancy outcomes after bariatric surgery, but only a small number have studied the impact of pregnancy on the postoperative outcomes. Purpose To study the effect of pregnancy on outcomes after bariatric surgery in women of childbearing age. Methods From January 2010 to October 2017, a retrospective study of a prospectively maintained database was conducted at the University Hospital of Geneva (HUG), where 287 women between the ages of 18 and 45 years had undergone Roux-en-Y gastric bypass (RYGB). A comparison of the results during a 5-year follow-up was performed between women who became pregnant after their bariatric surgery (pregnancy group, n = 40) and postoperative non-pregnant women (non-pregnancy group, n = 247). The two groups were compared for weight loss, complications, and nutritional deficiencies. Results The pregnancy group was significantly younger (29.2 ± 5.5 vs. 36.4± 6.3 years, p < 0.001) and heavier (124.0 ± 18.0 kg vs. 114.7 ± 17.1, p < 0.001) compared with the non-pregnancy group at the time of surgery. The percentage of excess BMI loss (%EBMI loss) was similar in both groups during the 5-year follow-up. Complications after RYGB and nutritional deficiencies were nearly identical in the two groups. The interval of time between bariatric surgery and first pregnancy was a median of 20.8 months. Out of 40 first pregnancies, 28 women completed pregnancy successfully with live birth. Conclusion Pregnancy after bariatric surgery is safe and does not adversely affect outcomes after RYGB. Keywords Bariatric surgery . Pregnancy . Roux-en-Y gastric bypass . Outcomes
Introduction The ever-increasing worldwide obesity rate is responsible for several significant health issues, concerning in particular women of childbearing age. In 2016, a study conducted by the World Health Organization (WHO) showed that 39% of the world’s population over the age of 18 were overweight and 13% were obese (BMI > 30 kg/m2) [1]. In addition, obesity is related to disorders such as diabetes, hypertension, hyperlipidemia, and infertility [2]. Bariatric surgery has become a popular treatment for obesity and its comorbidities during the last 20 years [3–5]. In obese women, pregnancy is associated with a higher risk of gestational diabetes mellitus (GDM), gestational hypertension,
prematurity, malformation, infection, perinatal mortality, and cesarean section [6]. Bariatric surgery reduces GDM, hypertensive disorders, and fetal macrosomia but increases the risk of prematurity and small-for-gestational age [7–15]. More and more obese women of reproductive ages decide to undergo bariatric surgery, despite potential risks, such as induction of malnutrition, vitamin defi
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