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March 10, 2023
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Pregnancy after bariatric surgery may lower risks for adverse pregnancy outcomes

Fact checked byRichard Smith
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Pregnancy after receiving bariatric surgery was associated with decreased risks for preeclampsia, gestational diabetes or impaired fasting glucose and large for gestational age neonates, researchers reported in Obstetrics & Gynecology.

Perspective from Michelle A. Kominiarek, MD

“The study adds to growing evidence of the safety of giving birth after weight-loss surgery while emphasizing the importance of nutritional guidance during pregnancy for these patients,” Monique M. Hedderson, PhD, research scientist and associate professor in the department of health systems science at Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, told Healio. “Pregnancies occurring after a bariatric surgery need to be monitored closely to make sure the women are getting adequate nutrition to ensure fetal growth.”

Monique M. Hedderson, PhD, quote
Data were derived from Boller MJ, et al. Obstet Gynecol. 2023;doi:10.1097/AOG.0000000000005088.

This retrospective cohort study included 1,591 women who had undergone bariatric surgery (mean age, 34 years) and gave birth from 2012 to 2018. Researchers identified bariatric surgery history using the ICD codes and a clinical database. The bariatric surgery cohort was matched with 7,955 women who gave birth and did not undergo such surgery with 6.5% at healthy weight, 22.2% who had overweight and 69.1% with obesity.

The primary outcome was preterm birth, gestational hypertension, preeclampsia, impaired glucose tolerance or gestational diabetes, large for gestational age or small for gestational age neonates and cesarean delivery.

Results demonstrated that pregnancy after bariatric surgery, compared with the non-surgery cohort, was associated with decreased risks for preeclampsia (7.5% vs. 10.2%; adjusted RR = 0.72; 95% CI, 0.6-0.86), gestational diabetes or IFG (23.5% vs. 35%; aRR = 0.73; 95% CI, 0.66-0.8) and large for gestational age infants (10.6% vs. 19.9%; aRR = 0.56; 95% CI, 0.48-0.65) and an increased risk for small for gestational age infants (10.9% vs. 6.6%; aRR = 1.51; 95% CI, 1.28-1.78) in multivariate models.

In addition, researchers observed no significant differences in rates of preterm birth, gestational hypertension and cesarean delivery.

“Further research on how patients who have had bariatric surgery can manage nutrition during their pregnancy will be important,” Hedderson said. “This study highlights the need for more detailed understanding of how the multiple factors that relate to both metabolic health and a healthy pregnancy interact.”

For more information:

Monique M. Hedderson, PhD, can be reached at monique.m.hedderson@kp.org.