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Maternal impacts and perinatal outcomes after three types of bariatric surgery at a single institution

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Bariatric surgery is widely known to improve pregnancy outcomes and to increase the risk of having small for gestational age neonates. However, the specific causes of neonatal growth restriction are still unclear. This study aimed to investigate the impacts of bariatric surgery on pregnancy and perinatal status at a single institution.

Methods

24 women delivered singleton births among the 193 reproductive-aged women who underwent bariatric surgery. We classified the surgery into three types: laparoscopic adjustable gastric banding (LAGB; n = 6), laparoscopic sleeve gastrectomy (LSG; n = 5), and malabsorptive surgery (MS; n = 13), and investigated the pregnancy complications and perinatal impacts.

Results

The median maternal weight gain after LAGB was 12.5 kg (LSG 6.9 kg, MS 9.0 kg). Gestational hypertension was observed in half of the women who underwent LAGB, but in none of those who underwent MS. No significant difference in neonatal birth weight was observed between the LAGB (median 3272 g) and LSG (median 3005 g) groups. The maternal impact after MS was a remarkable decrease in hemoglobin during prepregnancy (median 1.9 g/dl). About 69% of women developed gestational anemia after MS, and their neonatal birth weight was the lowest (median 2660 g). However, the birth weight of neonates delivered by mothers without anemia after undergoing MS was similar to that of those delivered by mothers after undergoing other types of bariatric surgery (median 3037 g).

Conclusions

Maternal anemia after MS may lead to low neonatal birth weight, which could be attributed to the large-scale reduction in maternal micronutrient levels.

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Author information

Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Atsushi Watanabe

  2. Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, 7-7 Nibancho, Chiyoda-ku, Tokyo, 102-0084, Japan

    Atsushi Watanabe, Yosuke Seki, Hidenori Haruta, Eri Kikkawa & Kazunori Kasama

  3. Clinical Institute of Digestive Disease Surgical Branch, Jichi Medical University, 3311-1 Yakushiji, Shimotsukeshi, Tochigi, 329-0498, Japan

    Hidenori Haruta

Authors
  1. Atsushi Watanabe
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  2. Yosuke Seki
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  3. Hidenori Haruta
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  4. Eri Kikkawa
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  5. Kazunori Kasama
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Contributions

AW and KK conceived of the presented idea. AW designed the study, and wrote the initial draft of the manuscript. EK and HH supported to analysis and interpretation of data, and assisted in the preparation of the manuscript. SY and KK supervised the findings of this work. All other authors have contributed to data collection and interpretation, and critically reviewed the manuscript. All authors approved the final version of the manuscript, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Atsushi Watanabe.

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All other authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Watanabe, A., Seki, Y., Haruta, H. et al. Maternal impacts and perinatal outcomes after three types of bariatric surgery at a single institution. Arch Gynecol Obstet 300, 145–152 (2019). https://doi.org/10.1007/s00404-019-05195-9

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  • DOI: https://doi.org/10.1007/s00404-019-05195-9

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