Timing of pregnancy after bariatric surgery: preliminary results.

The results and conclusions in this abstract are drawn from an ongoing study about pregnancy after bariatric surgery.

Background

Current recommendations indicate to avoid pregnancy 12 to 18 months postoperatively due to active weight loss and increased risk of nutritional deficiencies. However, no high-quality evidence supports this recommendation.

Objectives

To examine the association between surgery-to-conception interval and (i) pregnancy and neonatal complications, (ii) gestational weight gain and (iii) nutritional status.

Methods

In total, 97 female bariatric patients who sought obstetric care at one of the participating centres were included in this study. Retrospective data of 117 pregnancies on pregnancy course and outcomes was collected and analysed.

Results

The percentage of women who conceived after 12 or 18 months following surgery was 23.9% and 38.5%, respectively. Time between surgery and conception was not associated with neonatal complications such a low birthweight or NICU admission. However, a surgery-to-conception interval of 12 months was associated with significantly less weight gain during pregnancy (-3.6 kg vs 11.2 kg, p <0.0001). Insufficient gestational weight gain was associated with a lower gestational age at delivery (265 days vs 275 days, p <0.01). Despite using supplementation, nutritional deficiencies were frequently found for albumin (54%), calcium (35%), vitamin D (29%) and ferritin (27%). The prevalence of these deficiencies was not associated with the surgery-to-conception interval.

Conclusion

We conclude that for bariatric patients, pregnancy after the first 12–18 months seems safe as prevalence of obstetric and/or neonatal complications is low. However, practitioners should recommend a safe interval of one year to minimize the risk of insufficient gestational weight gain. Besides, special attention and treatment of maternal nutritional deficiencies during pregnancy is important.

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