Maternal-Fetal Medicine

Archives of Gynecology and Obstetrics

, Volume 285, Issue 3, pp 559-566

Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges

  • Ronis MagdalenoJrAffiliated withDepartment of Medical Psychology and Psychiatry, State University of Campinas (UNICAMP) Email author 
  • , Belmiro Gonçalves PereiraAffiliated withDepartment of Tocogynecology, State University of Campinas (UNICAMP)
  • , Elinton Adami ChaimAffiliated withDepartment of Surgery, Bariatric Surgery Ambulatory of General Hospital, State University of Campinas (UNICAMP)
  • , Egberto Ribeiro TuratoAffiliated withDepartment of Medical Psychology and Psychiatry, Laboratory of Clinical-Qualitative Research, University of Campinas (UNICAMP)

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Abstract

With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstetrical and perinatal implications of pregnancy following BS.

Methods

English, Spanish and Portuguese-language articles were identified in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding.

Results

The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauterine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery-to-conception interval. Deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium can result in maternal and fetal complications.

Conclusions

Pregnancy outcome of women who delivered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient’s individual requirements can prevent nutrition-related complications and improve maternal and fetal health.

Keywords

Bariatric surgery Pregnancy Pregnancy complications Morbid obesity Weight loss