Impact of Laparoscopic Adjustable Gastric Banding on Pregnancy, Maternal Weight, and Neonatal Health
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Laparoscopic adjustable gastric banding (LAGB) is a proven method for weight reduction. Less is known about pregnancies in patients after LAGB.
Information was gathered, through database and survey, on women who underwent LAGB at NYU Medical Center between 2001 and 2008 then became pregnant.
Pregnancy occurred in 133 women, resulting in 112 babies, including six sets of twins. The average pre-pregnancy body mass index (BMI) was 32.7. Average weight gain was 11.5 kg, but was higher for those with pre-pregnancy BMI <30.0 compared to BMI >30.0 (16.4 vs 8.6 kg). Of singleton pregnancies, 89% were carried to full term, with cesarean section in 45%. Those with pre-pregnancy BMI <30.0 had a lower rate of cesarean section (35.71%), but it was not statistically significant (p = 0.55). Average birth weight was 3,268.6 g. Eight percent of babies from singleton pregnancies were low birth weight (<2,500 g), and seven percent were high birth weight (>4,000 g). Average Apgar scores at 1 and 5 min were 8.89 and 9.17. Four percent of patients developed gestational diabetes, and 5% developed pre-eclampsia. Band adjustments were performed in 71% of patients. Weight gain was higher in those who had their bands loosened in the first trimester (p = 0.063). Three patients had intrapartum band slips; one required surgery during pregnancy.
LAGB is tolerable in pregnancy with rare intrapartum band slips. Weight gain is less in those with higher pre-pregnancy BMI and those who had their bands filled or not adjusted. Babies born to these mothers are as healthy as the general population.
KeywordsGastric banding Pregnancy Weight loss Gestational diabetes
Drs. Ren, Fielding, and Kurian were the primary surgeons and completed follow-up visits postoperatively. Dr. Friedman, Mr. Lok, Ms. Youn, and Ms. Finger contributed to data collection. G. Craig Wood contributed to statistical analysis. Dr. Carelli contributed to data collection, analysis, and authorship of this manuscript. Dr. Ren had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Conflicts of interest
Drs. Ren, Fielding, and Kurian receive educational and research grants from Allergan and are on the advisory board; however, none were utilized for the purposes of this study. The remaining authors have nothing to disclose.
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