Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass.

OBJECTIVE: To compare perinatal and pregnancy outcomes including adherence to the Institute of Medicine's (IOM) recommendations for gestational weight gain (GWG) in pregnant women with conception <18 months (early group) compared to ≥18 months following gastric bypass (late group). METHODS: Retrospective cohort study comprising 71 women with gastric bypass and a singleton pregnancy presenting at Odense University Hospital, November 2007-October 2013. Data were extracted from medical records and laboratory systems. The primary outcomes were timing of pregnancy and adherence to the IOM's recommendations for GWG. Secondary outcomes were birthweight, preterm delivery, cesarean section (CS), iron deficiency and post partum hemorrhage (PPH). RESULTS: Forty-three (61%) women conceived less than 18 months after gastric bypass surgery. Women in the late group had a significantly higher risk of requiring CS or receiving intravenous iron supplementation compared to the early group (57% versus 30%, p = 0.03 and 29% versus 7%, p = 0.02, respectively). Early conception was not significantly associated with insufficient GWG, preterm delivery or birthweight. Among 54 women with information on GWG, only 13 (24%) had an appropriate GWG. CONCLUSION: The majority of pregnant women with gastric bypass did not fulfill guidelines for GWG; however, this study could not support the recommendation to postpone pregnancy.

[Pregnancy after bariatric surgery].

This is a review of the recommendations regarding pregnancy after bariatric surgery from the Danish Society of Obstetrics and Gynaecology. The risk of vitamin/mineral deficiencies should be emphasized and checked with blood samples. Measurements of fetal growth should be offered at gestational age 28 and 34 as a supplement to the standard prenatal procedures because of the increased risk of intrauterine growth retardation. Because of persistent obesity there is still an increased risk of hypertension and diabetes mellitus. In case of abdominal pain internal herniation should be suspected.