Pregnancy after Gastric Bypass Surgery in Adolescents
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There is no previous research or documentation of the incidence of pregnancy or pregnancy outcomes in female adolescents after undergoing bariatric surgery.
Retrospective chart reviews were conducted for female patients who had bariatric surgery in our adolescent program from 2001–2007. Descriptive and clinical data were abstracted from the medical records, including data from the initial assessment and from follow-up clinic visits pre- and postoperatively.
47 adolescents (age <19 years) underwent Roux-en-Y gastric bypass (RYGBP). 7 pregnancies occurred in 6 Caucasian females and resulted in 6 reported healthy term deliveries (1 pending). 6 of the 7 pregnancies were conceived between 10 and 22 months following surgery. In this small cohort of adolescent females, the pregnancy rate was 12.8%.
The program pregnancy rate for adolescent females in this cohort was greater than anticipated, compared with national pregnancy rates for age and race-matched females in the USA. Risk factors that may contribute to an increased incidence of adolescent pregnancy in this unique bariatric population are unclear, but may include poor adherence to contraceptive therapy and psychosocial factors. Further research is required to define risk factors, improve adherence to contraceptive therapy, and encourage postponement of pregnancy after surgery.
- Freedman DS, Mei Z, Srinivasan SR et al. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 2007; 150: 12–7 E2. CrossRef
- Tsai WS, Inge TH, Burd RS. Bariatric surgery in adolescents: recent national trends in use and in-hospital outcome. Arch Pediatr Adolesc Med 2007; 161: 217–21. CrossRef
- Lawson ML, Kirk S, Mitchell T et al. One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group. J Pediatr Surg 2006; 41: 137–43; discussion 43. CrossRef
- Sugerman HJ, Sugerman EL, DeMaria EJ et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg 2003; 7:102–7; discussion 7–8. CrossRef
- Strauss RS, Bradley LJ, Brolin RE. Gastric bypass surgery in adolescents with morbid obesity. J Pediatr 2001; 138: 499–504. CrossRef
- Apovian CM, Baker C, Ludwig DS et al. Best practice guidelines in pediatric/adolescent weight loss surgery. Obes Res 2005; 13: 274–82.
- ACOG Committee Opinion number 315, September 2005. Obesity in pregnancy. Obstet Gynecol 2005; 106: 671–5.
- Xanthakos SA, Daniels SR, Inge TH. Bariatric surgery in adolescents: an update. Adolesc Med Clin 2006; 17: 589–612; abstract x.
- Wittgrove AC, Jester L, Wittgrove P et al. Pregnancy following gastric bypass for morbid obesity. Obes Surg 1998; 8: 461–4; discussion 5–6. CrossRef
- Dao T, Kuhn J, Ehmer D et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg 2006; 192: 762–6. CrossRef
- Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 2005; 106 (5 Pt 1): 965–72.
- Marceau P, Kaufman D, Biron S et al. Outcome of pregnancies after biliopancreatic diversion. Obes Surg 2004; 14: 318–24. CrossRef
- Inge T, Wilson KA, Gamm K et al. Preferential loss of central (trunk) adiposity in adolescents and young adults after laparoscopic gastric bypass. Surg Obes Relat Dis 2007; 3: 153–8. CrossRef
- Alan Guttmacher Institute. U.S. teenage pregnancy statistics national and state trends and trends by race and ethnicity, New York: Alan Guttmacher Institute, updated 2006. (Accessed May 28, 2007, at www.guttmacher.org/pubs/2006/09/12/USTPstats.pdf)
- Raatikainen K, Heiskanen N, Heinonen S. Transition from overweight to obesity worsens pregnancy outcome in a BMI-dependent manner. Obesity (Silver Spring) 2006; 14: 165–71. CrossRef
- Woodard CB. Pregnancy following bariatric surgery. J Perinat Neonatal Nurs 2004; 18: 329–40.
- Huerta S, Rogers LM, Li Z et al. Vitamin A deficiency in a newborn resulting from maternal hypovitaminosis A after biliopancreatic diversion for the treatment of morbid obesity. Am J Clin Nutr 2002; 76: 426–9.
- Rapoff MA. Adherence to pediatric medical regimens. New York: Kluwer Academic/Plenum; 1999.
- Rand CS, Macgregor AM. Adolescents having obesity surgery: a 6-year follow-up. South Med J 1994; 87: 1208–13.
- Towbin A, Inge TH, Garcia VF et al. Beriberi after gastric bypass surgery in adolescence. J Pediatr 2004; 145: 263–7. CrossRef
- Hillard PJ. Overview of contraception. Adolesc Med Clin 2005; 16: 485–93. CrossRef
- Klein JD. Adolescent pregnancy: current trends and issues. Pediatrics 2005; 116: 281–6. CrossRef
- Zabin LS, Huggins GR, Emerson MR et al. Partner effects on a woman’s intention to conceive: ‘not with this partner’. Fam Plann Perspect 2000; 32: 39–45. CrossRef
- Rosengard C, Pollock L, Weitzen S et al. Concepts of the advantages and disadvantages of teenage childbearing among pregnant adolescents: a qualitative analysis. Pediatrics 2006; 118: 503–10. CrossRef
- Flanagan P, Kokotailo P. Adolescent pregnancy and substance use. Clin Perinatol 1999; 26: 185–200.
- Biglan A, Metzler CW, Wirt R et al. Social and behavioral factors associated with high-risk sexual behavior among adolescents. J Behav Med 1990; 13: 245–61. CrossRef
- Clark AM, Ledger W, Galletly C et al. Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. Hum Reprod 1995; 10: 2705–12.
- Kral JG, Biron S, Simard S et al. Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years. Pediatrics 2006; 118: E1644–9. CrossRef
- Pregnancy after Gastric Bypass Surgery in Adolescents
Volume 17, Issue 7 , pp 873-877
- Cover Date
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- Morbid obesity
- bariatric surgery
- gastric bypass
- Industry Sectors
- Author Affiliations
- 1. Assistant Professor of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- 6. Behavioral Medicine and Clinical Psychology, ML 3015, Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
- 2. Assistant Professor of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Medical Director of the Surgical Weight Loss Program for Teens, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- 3. Pediatric Nurse Practitioner, Division of Pediatric and Thoracic Surgery, Bariatric Nurse Coordinator of the Surgical Weight Loss Program for Teens, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- 4. Associate Professor of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- 5. Associate Professor of Surgery and Pediatrics, Division of Pediatric and Thoracic Surgery, Surgical Director of the Surgical Weight Loss Program for Teens, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA