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Pregnancy after Bariatric Surgery: Obstetric and Perinatal Outcomes and the Growth and Development of Children

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Abstract

Background

Several outcomes of pregnancy after bariatric surgery are currently being studied.

Methods

This cross-sectional, retrospective study evaluated the obstetric and perinatal outcomes of pregnancies in 19 women who underwent bariatric surgery, as well as the growth and development of their children, in the Southern Brazil.

Results

Among these women, 11 children were born prior to surgery and 32 were born post-surgery. The mean time between the surgery and the first pregnancy was 42.96 months. Preterm newborns were more common among the pre-surgery childbirths. Regarding growth, normal weights were observed in 27.3 % of the children in the pre-surgery births and obesity was observed in 54.5 %. In contrast, normal weights were observed in 59.4 % of the children born during the postoperative period and obesity was observed in 31.2 %. The average excess weight that the women lost prior to pregnancy was 64.88. Speech delays were found in three male children evaluated using the Denver Developmental Screening Test II. A statistical association was found between the interval from the surgery to the pregnancy and the outcome of the questionable Denver II test results (p = 0.011).

Conclusions

Except for the large index of low birth weight, it can be concluded that pregnancy after bariatric surgery is safe. The growth rate was found to be adequate in the children born after the surgery, with reduced obesity. Although changes in speech development were detected, no factors were supported an association with pregnancy after bariatric surgery.

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References

  1. Obesity and overweight. What are overweight and obesity? Fact sheet n° 311; September, 2006. World Health Organization, 2006. Available: http://www.who.int/mediacentre/facsheets/fs311/en/print.html Accessed 20 Jan 2008.

  2. Centers for Disease Control and Prevention. Vital signs: statespecific obesity prevalence among adults–United States, 2009. MMWR Morb Mortal Wkly Rep. 2010;59:951–5.

    Google Scholar 

  3. Embonpoint et obésité chez les adultes (mesures autodéclarées). Statistique Canada, 2011. Available: http://www.statcan.gc.ca/pub/82-625-x/2012001/article/c-g/desc/11664-01-desc-fra.htm Accessed 15 Jan 2013.

  4. Dao T et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192:762–6.

    Article  PubMed  Google Scholar 

  5. Committee Opinion 315: obesity in pregnancy. American College of Obstetricians And Gynecologists. Obstet Gynecol. 2005;106:671–75.

  6. Murakami M et al. Prepregnancy body mass índex as an important predictor of perinatal outcomes in japanese. Arch Gynecol Obstet. 2005;271:311–5.

    Article  PubMed  Google Scholar 

  7. Cnattingius S et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309:2362–70.

    Article  CAS  PubMed  Google Scholar 

  8. Singh J et al. The impact of pre-pregnancy body mass index on the risk of gestational diabetes. J Matern Fetal Neonatal Med. 2012;25:5–10.

    Article  PubMed  Google Scholar 

  9. Wash SW. Obesity: a risk factor for preeclampsia. Trends Endocrinol Metab. 2007;18:365–70.

    Article  Google Scholar 

  10. Persson M et al. Pre-pregnancy body mass index and the risk of adverse outcome in type 1 diabetic pregnancies: a population-based cohort study. BMJ Open. 2012;2:e000601.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Yazdani S et al. Effect of maternal body mass index on pregnancy outcome and newborn weight. BMC Res Notes. 2012;5:34.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Machado LS. Cesarean section in morbidly obese parturients: practical implications and complications. N Am J Med Sci. 2012;4:13–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Dodd JM et al. Limiting weight gain in overweight and obese women during pregnancy to improve health outcomes: the LIMIT randomised controlled trial. BMC Pregnancy Childbirth. 2011;11:79.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Seabra G et al. Pregestational overweight and obesity: Prevalence and outcome associated with pregnancy. Rev Bras Ginecol Obstet. 2011;33:348–53.

    PubMed  Google Scholar 

  15. Davies GA et al. Obesity in pregnancy. J Obstet Gynaecol Can. 2010;32:165–73.

    PubMed  Google Scholar 

  16. Smith J et al. Effects of maternal surgical weight loss in mothers on intergenerational transmission of obesity. J Clin Endocrinol Metab. 2009;94:4275–83.

    Article  CAS  PubMed  Google Scholar 

  17. Eerdekens A et al. Maternal bariatric surgery: Adverse outcomes in neonates. Eur J Pediatr. 2010;169:191–6.

    Article  CAS  PubMed  Google Scholar 

  18. Dalfrà MG et al. Pregnancy and foetal outcome after bariatric surgery: a review of recent studies. J Matern Fetal Neonatal Med. 2012;25:1537–43.

    Article  PubMed  Google Scholar 

  19. Buchwald H et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  CAS  PubMed  Google Scholar 

  20. Sjostrom L et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  21. Pope GD, Birkmeyer JD, Finlayson SR. National trends in utilization and in-hospital outcomes of bariatric surgery. J Gastrointest Surg. 2002;6:855–60.

    Article  PubMed  Google Scholar 

  22. Flegal KM et al. Prevalence and trends in obesity among U.S. adults, 1999–2000. JAMA. 2002;288:1723–7.

    Article  PubMed  Google Scholar 

  23. Maggard MA et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300:2286–96.

    Article  CAS  PubMed  Google Scholar 

  24. Tice JA, Karliner L, Walsh J. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121:885–93.

    Article  PubMed  Google Scholar 

  25. Patel JA et al. Pregnancy outcomes after laparoscopic Roux-en-Y gastric by-pass. Surg Obes Relat Dis. 2008;4:39–45.

    Article  PubMed  Google Scholar 

  26. Wax JR et al. Pregnancy following gastric bypass surgery for morbid obesity: Maternal and neonatal outcomes. Obes Surg. 2008;18:540–4.

    Article  PubMed  Google Scholar 

  27. Ducarme G et al. Obstetric outcome following laparoscopic adjustable gastric banding. Int J Gynaecol Obstet. 2007;98:244–7.

    Article  CAS  PubMed  Google Scholar 

  28. Sheiner E et al. Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Am J Obstet Gynecol. 2004;190:1335–40.

    Article  PubMed  Google Scholar 

  29. Dixon JB, Dixon ME, O’brien PE. Quality of life after lap-band placement: Influence of time, weight loss, and comorbidities. Obes Res. 2001;9:713–21.

    Article  CAS  PubMed  Google Scholar 

  30. Weintraub AY et al. Effect of bariatric surgery on pregnancy outcome. Int J Gynecol Obstet. 2008;103:246–51.

    Article  Google Scholar 

  31. Beard JH, Bell RL, Dufty AJ. Reproductive considerations and pregnancy after bariatric surgery: Current evidence and recommendations. Obes Surg. 2008;8:1023–7.

    Article  Google Scholar 

  32. Lima JG et al. Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura. Rev Bras Ginecol Obstet. 2006;28:107–11.

    Article  Google Scholar 

  33. Marceau P et al. Outcome of pregnancies after biliopancreatic diversion. Obes Surg. 2004;14:318–24.

    Article  PubMed  Google Scholar 

  34. Guelinckx I, Devlieger R, Vansant G. Reprodutive outcome after bariatric surgery: a critical review. Hum Reprod Update. 2009;15:189–201.

    Article  PubMed  Google Scholar 

  35. Huerta S 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.

    CAS  PubMed  Google Scholar 

  36. Martin LF, Finigan KM, Nolan TE. Pregnancy after adjustablegastric banding. Obstet Gynecol. 2000;95:927–30.

    Article  CAS  PubMed  Google Scholar 

  37. Josefsson A et al. Bariatric surgery in a national cohort of women: Sociodemographics and obstetric outcomes. Am J Obstet Gynecol. 2011;205:206 e1-8.

    PubMed  Google Scholar 

  38. Lesko J, Peaceman A. Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls. Obstet Gynecol. 2012;119:547–54.

    Article  PubMed  Google Scholar 

  39. Kjaer MM et al. The risk of adverse pregnancy outcome after bariatric surgery: a nationwide register-based matched cohort study. Am J Obstet Gynecol. 2013;208:464 e1-5.

    PubMed  Google Scholar 

  40. Santo MA, Riccioppo D, Cecconello I. Tratamento cirúrgico da obesidade mórbida – implicações gestacionais. Rev Assoc Med Bras. 2010;56:615–37.

    Article  Google Scholar 

  41. Moliterno JA et al. Gastric bypass: a risk factor for neural tube defects? Case report. J Neurosurg Pediatr. 2008;1:406–9.

    Article  PubMed  Google Scholar 

  42. Poitou-Bernet C et al. Nutritional deficiency after gastric bypass: Diagnosis, prevention, treatment. Diabetes Metab. 2007;33:13–24.

    Article  Google Scholar 

  43. Karmon A, Sheiner E. Pregnancy after bariatric surgery: a comprehensive review. Arch Gynecol Obstet. 2008;277:381–8.

    Article  PubMed  Google Scholar 

  44. Sheiner E et al. Pregnancy outcome of patients with gestational diabetes mellitus following bariatric surgery. Am J Obstet Gynecol. 2006;194:431–5.

    Article  PubMed  Google Scholar 

  45. Global database on Body Mass Index. BMI classification. World Health Organization, 2006. Available: http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed 24 Aug 2009.

  46. Pediatric and Pregnancy Nutrition Surveillance System. PedNSS Health Indicators. Centers for Disease Control and Prevention, 2009. Available: http://www.cdc.gov/pednss/what_is/pednss_health_indicators.htm#birthweight. Accessed 25 Sep 2013.

  47. Media centre. Preterm birth. World Health Organization, 2012. Fact sheet N°363. Available: http://www.who.int/mediacentre/factsheets/fs363/en/ Accessed 10 Sep 2013.

  48. Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world’s children. Geneva. World Health Organization, 2010. Available: http://www.who.int/childgrowth/software/en/ Accessed 10 Jan 2014.

  49. Child Growth Standards, 2014. World Health Organization, 2014. Available: http://www.who.int/childgrowth/standards/en/ Accessed 10 Jan 2014.

  50. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press. Institute of Medicine, 2009. Available: http://www.iom.edu/∼/media/Files/Report%20Files/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines/Report%20Brief%20-%20Weight%20Gain%20During%20Pregnancy.pdf Accessed 22 Feb 2013.

  51. Bray GA et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17:619–21.

    Article  PubMed  Google Scholar 

  52. Alatishe A et al. Bariatric surgery in women of childbearing age. Q J Med. 2013;106:717–20.

    Article  CAS  Google Scholar 

  53. Frankenburg KW et al. Denver II: technical manual and training manual. Denver: Denver Developmental Materials; 1990.

    Google Scholar 

  54. Laville M, Loireau A. 3es Rencontres médecins-chirurgiens sur la chirurgie de l’obesité Projet de grossesse et chirurgie bariatrique: quells conseils? Obésité. 2009;4:163–5.

    Article  Google Scholar 

  55. Siega-Riz AM et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: Birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009;201:339.e1–14.

    Article  Google Scholar 

  56. Amorim AR et al. Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity (Silver Spring). 2007;15:1278–86.

    Article  Google Scholar 

  57. Nehring I et al. Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr. 2011;94:1225–31.

    Article  CAS  PubMed  Google Scholar 

  58. Mamun AA et al. Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: evidence from 21 y postpartum follow-up. Am J Clin Nutr. 2010;91:1336–41.

    Article  CAS  PubMed  Google Scholar 

  59. Thorsdottir I et al. Weight gain in women of normal weight before pregnancy: Complications in pregnancy or delivery and birth outcome. Obstet Gynecol. 2002;99:799–806.

    Article  PubMed  Google Scholar 

  60. Han Z et al. Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses. Acta Obstet Gynecol Scand. 2011;90:935–54.

    Article  PubMed  Google Scholar 

  61. Langford A et al. Does gestational weight gain affect the risk of adverse maternal and infant outcomes in overweight women? Matern Child Health J. 2011;15:860–5.

    Article  PubMed  Google Scholar 

  62. Oken E et al. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. Am J Epidemiol. 2009;170:173–80.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Schack-Nielsen L et al. Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood. Int J Obes. 2010;34:67–74.

    Article  CAS  Google Scholar 

  64. Committee Opinion, number 549 (Replaces n. 315, September, 2005). Obesity in pregnancy. American College Of Obstetricians And Gynecologists2, 2013. Available: http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Weight%20Gain%20During%20Pregnancy.aspx Accessed 22 Feb 2013.

  65. Roos N et al. Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study. BMJ. 2013;347:f6460. doi:10.1136/bmj.f6460.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Sheiner E et al. Pregnancy outcome in patients following different types of bariatric surgeries. Obes Surg. 2009;19:1286–92.

    Article  PubMed  Google Scholar 

  67. Dell’agnolo CM, Carvalho MDB, Pelloso MS. Pregnancy after bariatric surgery: implications for mother and newborn. Obes Surg. 2011;21:699–706.

    Article  PubMed  Google Scholar 

  68. Iavazzo C et al. Complications in pregnancy after bariatric surgery. Arch Gynecol Obstet. 2010;282:225–7.

    Article  CAS  PubMed  Google Scholar 

  69. Sheiner E et al. Pregnancyoutcome of patients who conceive during or after the first year following bariatric surgery. Am J Obstet Gynecol. 2011;204(50):e1–6.

    PubMed  Google Scholar 

  70. Schirmer CR, Portuguez MW, Nunes ML. Clinical Assessment of language development in children at age 3 years that were born preterm. Arq Neuropsiquiatr. 2006;64:926–31.

    Article  PubMed  Google Scholar 

  71. Rothkopf MM. Reversible neurologic dysfunction caused by severe vitamin deficiency after malabsorptive bariatric surgery. Surg Obes Relat Dis. 2006;2:656–60.

    Article  PubMed  Google Scholar 

  72. Van Mieghem T et al. Fetal cerebral hemorrhage caused by vitamin K deficiency after complicated bariatric surgery. Obstet Gynecol. 2008;112:434–6.

    Article  PubMed  Google Scholar 

  73. Whitehouse AJ et al. Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development. Pediatrics. 2012;129:485–93.

    Article  PubMed  Google Scholar 

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This study is in accordance with the ethical standards and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. It was approved by the Ethics Research Committee of the State University of Maringa.

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

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Post Graduate Program in Nursing, Maringa State University, Parana, Brazil

    Cátia Millene Dell’Agnolo & Sandra Marisa Pelloso

  2. Research, Québec University, Gatineau, QC, Canada

    Caroline Cyr

  3. Department of Nursing, Québec University, Gatineau, QC, Canada

    Francine de Montigny

  4. Department of Medicine, Maringa State University, Maringa, Parana, Brazil

    Maria Dalva de Barros Carvalho

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  1. Cátia Millene Dell’Agnolo
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  2. Caroline Cyr
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  3. Francine de Montigny
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  4. Maria Dalva de Barros Carvalho
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  5. Sandra Marisa Pelloso
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Correspondence to Cátia Millene Dell’Agnolo.

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Dell’Agnolo, C.M., Cyr, C., de Montigny, F. et al. Pregnancy after Bariatric Surgery: Obstetric and Perinatal Outcomes and the Growth and Development of Children. OBES SURG 25, 2030–2039 (2015). https://doi.org/10.1007/s11695-015-1668-9

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  • DOI: https://doi.org/10.1007/s11695-015-1668-9

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