Obesity is a known risk factor for complications during pregnancy and birth such as gestational diabetes, preeclampsia, stillbirth, macrosomia, and birth defects. Bariatric surgery, or weight loss surgery, refers to a number of surgical procedures that help obese individuals lose weight. Now a new study published in the New England Journal of Medicine concludes that bariatric surgery affects the risk of pregnancy and birth complications, both positively and negatively influencing the risk.
Using data from nationwide Swedish health registries, researchers from Karolinska Institutet in Sweden identified 596 pregnancies to women who had given birth after bariatric surgery between 2006 and 2011. The researchers then compared the pregnancies with 2,356 pregnancies in women with the same body mass index (BMI) as the first group prior to surgery but who had not undergone bariatric surgery.
Says lead author Kari Johansson, PhD, of the Department of Medicine in Solna
“The effects of bariatric surgery on health outcomes such as diabetes and cardiovascular disease have been studied, but less is known about the effects on pregnancy and perinatal outcomes. Therefore we wanted to investigate if the surgery influenced in any way the risk of gestational diabetes, preterm birth, stillbirth, if the baby was small or large for its gestational age, congenital malformations and neonatal death.”
According to the study, women who had undergone bariatric surgery prior to pregnancy were much less likely to develop gestational diabetes compared to women with the same BMI who had not undergone surgery, 2 percent versus 7 percent respectively. Bariatric surgery also decreased the risk of macrosomia, or babies born large for gestational age, at 9 percent among women in the surgery group versus 22 percent among women in the control group.
However, women in the bariatric surgery group were twice as likely to give birth to babies considered small for gestational age compared to women in the control group. Women who had undergone bariatric surgery also had pregnancies of shorter duration than the women who had not undergone surgery.
The number of women who become pregnant after bariatric surgery increased sharply in Sweden in recent years. Of the 8,000 performed in 2013, women accounted for 80 percent of the surgeries. The present study indicates that maternal health services should regard pregnancies after bariatric surgery as risk pregnancies.
Concludes Dr. Johansson:
“Since bariatric surgery followed by pregnancy has both positive and negative effects, these women, when expecting, should be regarded as risk pregnancies. They ought to be given special care from the maternal health services, such as extra ultrasound scans to monitor fetal growth, detailed dietary advice that includes checking the intake of the necessary post-surgery supplements.”
Another study from 2013 concluded that women who have undergone bariatric surgery to lose weight are at an increased risk of giving birth prematurely and giving birth to babies with low birth weight compared to women who have not had weight loss surgery.
Bariatric surgery affects risk of pregnancy complications: http://www.medicalnewstoday.com/releases/289981.php
Pregnancy and obesity: Know the risks: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409
Obese Black Woman: https://www.flickr.com/photos/mlazarevski/9052142413/