Skip to main content

Advertisement

SpringerLink
Log in

Influence of Time Interval from Bariatric Surgery to Conception on Pregnancy and Perinatal Outcomes

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Introduction

Pregnancy in women submitted to bariatric surgery is increasing. Recommendations for surveillance of these pregnancies have been suggested, but an adequate time interval from surgery to conception, to avoid perinatal negative outcomes, is still controversial.

Material and Methods

Medical records of pregnancies in women with previous bariatric surgery were retrieved and outcomes were assessed according to three different time thresholds (12, 18 and 24 months). The association between time from surgery to conception and the presence of adverse outcomes was analysed.

Results

Eighty-six pregnancies were assessed. Weight gain was higher (p = 0.014) and more adequate (p = 0.041) when pregnancy occurred more than 12 months after surgery. Foetal growth percentile was lower when pregnancy was achieved before 24 months following surgery (p = 0.021). No differences among groups were found in other assessed outcomes (BMI, gestational age at delivery, type of delivery, gestational diabetes, pregnancy hypertensive disease, anaemia, preterm delivery, foetal weight, foetal growth restriction, Apgar score, admission to neonatal intensive unit) in all considered thresholds. No association between time from surgery to conception and the presence of adverse outcomes was found.

Conclusion

Despite differences found in maternal weight gain and foetal growth percentile, our study does not support the recommendation to delay pregnancy based on a fixed deadline. Other factors, including a more individualised approach, need to be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Organisation for Economic Co-operation and Development. Obesity Update 2017. 2017.

  2. do Carmo I, Dos Santos O, Camolas J, et al. Overweight and obesity in Portugal: national prevalence in 2003-2005. Obes Rev. 2008;9(1):11–9.

    PubMed  Google Scholar 

  3. Sardinha LB, Santos DA, Silva AM, et al. Prevalence of overweight, obesity, and abdominal obesity in a representative sample of Portuguese adults. PLoS One. 2012;7(10):e47883.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Mission JF, Marshall NE, Caughey AB. Pregnancy risks associated with obesity. Obstet Gynecol Clin N Am. 2015;42(2):335–53.

    Article  Google Scholar 

  5. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.

    Article  CAS  PubMed  Google Scholar 

  6. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300(19):2286–96.

    Article  CAS  PubMed  Google Scholar 

  7. Kwong W, Tomlinson G, Feig DS. Maternal and neonatal outcomes after bariatric surgery; a systematic review and meta-analysis: do the benefits outweigh the risks? Am J Obstet Gynecol. 2018;218(6):573–80.

    Article  PubMed  Google Scholar 

  8. Kassir R, Goiset MP, Williet N, et al. Bariatric surgery and pregnancy: what outcomes? Int J Surg. 2016;36(Pt A):66–7.

    Article  PubMed  Google Scholar 

  9. Johansson K, Cnattingius S, Naslund I, et al. Outcomes of pregnancy after bariatric surgery. N Engl J Med. 2015;372(9):814–24.

    Article  CAS  PubMed  Google Scholar 

  10. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–13.

    Article  Google Scholar 

  11. Alatishe A, Ammori BJ, New JP, et al. Bariatric surgery in women of childbearing age. QJM. 2013;106(8):717–20.

    Article  CAS  PubMed  Google Scholar 

  12. Apovian CM, Baker C, Ludwig DS, et al. Best practice guidelines in pediatric/adolescent weight loss surgery. Obes Res. 2005;13(2):274–82.

    Article  PubMed  Google Scholar 

  13. Monteiro M. Comment on: pregnancy after bariatric surgery: the effect of time-to-conception on pregnancy outcomes. Surg Obes Relat Dis. 2017;13(11):1905–7.

    Article  PubMed  Google Scholar 

  14. Royal College of Obstetricians & Gynaecologists. The role of bariatric surgery in improving reproductive health. 2015.

  15. Carreau A-M, Nadeau M, Marceau S, et al. Pregnancy after bariatric surgery: balancing risks and benefits. Can J Diabetes. 2017;41(4):432–8.

    Article  PubMed  Google Scholar 

  16. Menard MK, Kilpatrick S, Saade G, et al. Levels of maternal care. Am J Obstet Gynecol. 2015;212(3):259–71.

    Article  PubMed  Google Scholar 

  17. Moore KA, Ouyang DW, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. N Engl J Med. 2004;351(7):721–2.

    Article  CAS  PubMed  Google Scholar 

  18. Kjær MM, Nilas L. Timing of pregnancy after gastric bypass—a national register-based cohort study. Obes Surg. 2013;23(8):1281–5.

    Article  PubMed  Google Scholar 

  19. Stentebjerg LL, Andersen LLT, Renault K, et al. Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass. J Matern Fetal Neonatal Med. 2017;30(10):1182–8.

    Article  PubMed  Google Scholar 

  20. Yau PO, Parikh M, Saunders JK, et al. Pregnancy after bariatric surgery: the effect of time-to-conception on pregnancy outcomes. Surg Obes Relat Dis. 2017;13(11):1899–905.

    Article  PubMed  Google Scholar 

  21. González I, Rubio MA, Cordido F, et al. Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study. Obes Surg. 2015;25(3):436–42.

    Article  PubMed  Google Scholar 

  22. Dao T, Kuhn J, Ehmer D, et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192(6):762–6.

    Article  PubMed  Google Scholar 

  23. Wax JR, Cartin A, Wolff R, et al. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes Surg. 2008;18(12):1517–21.

    Article  PubMed  Google Scholar 

  24. Parent B, Martopullo I, Weiss NS, et al. Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications. JAMA Surg. 2017;152(2):1–8.

    Article  PubMed  Google Scholar 

  25. Dalfra MG, Busetto L, Chilelli NC, et al. Pregnancy and foetal outcome after bariatric surgery: a review of recent studies. J Matern Fetal Neonatal Med. 2012;25(9):1537–43.

    Article  PubMed  Google Scholar 

  26. Chevrot A, Kayem G, Coupaye M, et al. Impact of bariatric surgery on fetal growth restriction: experience of a perinatal and bariatric surgery center. Am J Obstet Gynecol. 2016;214(5):655 e1–7.

    Article  PubMed  Google Scholar 

  27. Frame-Peterson LA, Megill RD, Carobrese S, et al. Nutrient deficiencies are common prior to bariatric surgery. Nutr Clin Pract. 2017;32(4):463–9.

    Article  PubMed  Google Scholar 

  28. Gesquiere I, Foulon V, Augustijns P, et al. Micronutrient intake, from diet and supplements, and association with status markers in pre- and post-RYGB patients. Clin Nutr. 2017;36(4):1175–81.

    Article  CAS  PubMed  Google Scholar 

  29. Hue O, Marcotte J, Berrigan F, et al. Increased plasma levels of toxic pollutants accompanying weight loss induced by hypocaloric diet or by bariatric surgery. Obes Surg. 2006;16(9):1145–54.

    Article  PubMed  Google Scholar 

  30. Jansen A, Lyche JL, Polder A, et al. Increased blood levels of persistent organic pollutants (POP) in obese individuals after weight loss-a review. Toxicol Environ Health B Crit Rev. 2017;20(1):22–37.

    Article  CAS  Google Scholar 

  31. Ducarme G, Parisio L, Santulli P, et al. Neonatal outcomes in pregnancies after bariatric surgery: a retrospective multi-centric cohort study in three French referral centers. J Matern Fetal Neonatal Med. 2013;26(3):275–8.

    Article  PubMed  Google Scholar 

  32. Norgaard LN, Gjerris AC, Kirkegaard I, et al. Fetal growth in pregnancies conceived after gastric bypass surgery in relation to surgery-to-conception interval: a Danish national cohort study. PLoS One. 2014;9(3):e90317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Mahawar KK, Graham Y, Small PK. Optimum time for pregnancy after bariatric surgery. Surg Obes Relat Dis. 2016;12(5):1126–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Cátia Rasteiro, as principal investigator, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal

    Cátia Rasteiro, Célia Araújo, Sara Cunha, Rita Caldas & Joana Mesquita

  2. Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal

    Cátia Rasteiro

  3. Escola Superior de Saúde, Universidade Fernando Pessoa, Porto, Portugal

    Adérito Seixas

  4. LABIOMEP, INEGI-LAETA, Faculty of Sports, University of Porto, Porto, Portugal

    Adérito Seixas

  5. Faculdade de Ciências Sociais e Humanas, Universidade da Beira Interior, Covilhã, Portugal

    Nuno Augusto

  6. Centre for Research and Studies in Sociology, University Institute of Lisbon, Lisbon, Portugal

    Nuno Augusto

  7. Centro Hospitalar São João, EPE, Porto, Portugal

    Carla Ramalho

  8. Faculdade de Medicina da Universidade do Porto, Porto, Portugal

    Carla Ramalho

  9. Universidade do Porto, Instituto de Investigação e Inovação em Saúde, Porto, Portugal

    Carla Ramalho

Authors
  1. Cátia Rasteiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Célia Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sara Cunha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rita Caldas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joana Mesquita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Adérito Seixas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nuno Augusto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Carla Ramalho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cátia Rasteiro.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Statement of Human and Animal Rights

Not Applicable.

Statement of Informed Consent

For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rasteiro, C., Araújo, C., Cunha, S. et al. Influence of Time Interval from Bariatric Surgery to Conception on Pregnancy and Perinatal Outcomes. OBES SURG 28, 3559–3566 (2018). https://doi.org/10.1007/s11695-018-3395-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3395-5

Keywords

Search

Navigation