Pregnancy outcomes and nutritional indices after 3 types of bariatric surgery performed at a single institution.

Abstract

BACKGROUND:

Nutritional status during pregnancy and the effects of nutritional deficiencies on pregnancy outcomes after bariatric surgery is an important issue that warrants further study. The objective of this study was to investigate pregnancy outcomes and nutritional indices after restrictive and malabsorptive procedures.

METHODS:

We investigated pregnancy outcomes of 113 women who gave birth to 150 children after biliopancreatic diversion (BPD), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) between June 1994 and December 2011. Biochemical indices and pregnancy outcomes were compared among the different types of surgery and to overall 20-year hospital data, as well as to 56 presurgery pregnancies in 36 women of the same group.

RESULTS:

Anemia was observed in 24.2% and 15.6% of pregnancies after BPD and RYGB, respectively. Vitamin B12 levels decreased postoperatively in all groups, with no further decrease during pregnancy; however, low levels were observed not only after BPD (11.7%) and RYGB (15.6%), but also after SG (13.3%). Folic acid levels increased. Serum albumin levels decreased in all groups during pregnancy, but hypoproteinemia was seen only after BPD. Neonates after BPD had significantly lower average birth weight without a higher frequency of low birth weight defined as<2500 g. A comparison of neonatal data between babies born before surgery and siblings born after surgery (AS) showed that AS newborns had lower average birth weight with no significant differences in body length or head circumference and no cases of macrosomia.

CONCLUSION:

Our study showed reasonably good pregnancy outcomes in this sample population after all types of bariatric surgery provided nutritional supplement guidelines are followed. Closer monitoring is required in pregnancies after malabsorptive procedures especially regarding protein nutrition.

• Authors: Nancy C Mead, Panagiotis Sakkatos, George C Sakellaropoulos, George L Adonakis, Theodore K Alexandrides, Fotis Kalfarentzos
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2014 Nov-Dec Vol. 10 Issue 6 Pg. 1166-73 ISSN: 1878-7533 [Electronic] United States
• PMID: 24913588 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Analysis of Variance
• Biliopancreatic Diversion (adverse effects, methods)
• Birth Weight
• Body Mass Index
• Cohort Studies
• Female
• Gastrectomy (adverse effects, methods)
• Gastric Bypass (adverse effects, methods)
• Gestational Age
• Humans
• Infant, Newborn
• Laparoscopy (methods)
• Malnutrition (etiology, physiopathology)
• Maternal Age
• Nutritional Status
• Obesity, Morbid (diagnosis, surgery)
• Pregnancy
• Pregnancy Outcome
• Prenatal Care (methods)
• Retrospective Studies
• Risk Assessment
• Statistics, Nonparametric
• Vitamin B 12 Deficiency (etiology, physiopathology)
• Weight Loss