It is recommended that women wait at least two years after bariatric surgery before trying to conceive

It is recommended that women wait at least two years after bariatric surgery before trying to conceive

New research presented at the European Conference on Obesity (ECO) in Maastricht, Netherlands (4-7 May), suggests that women who have undergone weight-loss surgery should wait at least two years before trying to conceive.

Bariatric surgery is increasingly common in women of childbearing age and reduces the risk of complications associated with obesity during pregnancy, such as preeclampsia and gestational diabetes.

However, women are more likely to have a baby who is very underweight (small for gestational age, SGA), after bariatric surgery.

Babies who are very young at gestational age are at greater risk of developing a range of problems, including hypothermia, hypoglycemia, infections, and choking in newborns, of normal weight.

As a result, women are generally advised to wait at least 12 months after bariatric surgery before trying to conceive. Many European countries, including the United Kingdom, recommend waiting 2 years after gastric banding and 12 months after other types of bariatric surgery.

However, the optimal period from bariatric surgery to pregnancy (BSCI) has not been established.

To learn more, Dr. Ana Carrera and Dr. Barbara Araujo, Department of Endocrinology and Metabolism, Centro Hospital e Universitario de Coimbra, Coimbra, Portugal, and colleagues conducted a retrospective study of 48 pregnancies after bariatric surgery.

The women were 34.3 years old, on average, at conception, and had a mean BMI of 30.9.

They underwent the following types of bariatric surgery: gastric bypass (37.5%), sleeve gastrectomy (35.4%), gastric banding (22.9%), and pancreatic-biliary diversion (4.2%).

14.6% of the children were born less than 12 months after bariatric surgery, another 14.6% at 12 to 24 months after surgery and 70.8% had a BSCI for more than 24 months.

The mean birth weight was 2,980 g and 26.3% of the infants were SGA (defined in this study as being smaller than >90% of the infants born within the same number of weeks gestation).

The time from bariatric surgery to pregnancy was significantly lower in the SGA children (23.1 months versus 64.7 months).

The analysis also revealed that the longer a woman waits to conceive, the lower her chances of having an SGA baby.

Waiting for each additional month was associated with a 5% lower risk of having a baby and a 4.2g increase in birth weight.

The optimal waiting time was found to be at least 24.5 months. Women with BSCI less than 24.5 months old were 15 times more likely to have an SGA baby than those who waited longer to conceive.

Finally, the risk of having an SGA baby was similar for different types of bariatric surgery.

Dr Araujo says: “The period of bariatric surgery until pregnancy has a significant impact on birth weight, with shorter periods associated with an increased risk of having a very thin baby.

“This is likely due to the rapid weight loss that occurs after bariatric surgery which makes it difficult for a woman to gain adequate weight during pregnancy. Rapid weight loss can also lead to nutritional deficiencies that may be harmful to the baby.”

“The longer interval from surgery to pregnancy allows a woman’s weight and nutritional status to stabilize.”

We recommend that women wait at least two years after bariatric surgery before trying to conceive, regardless of the type of surgery.

While it may be possible to modify this slightly on an individual basis, it is important that women undergoing bariatric surgery are aware of the risk of early pregnancy and the benefits of delaying pregnancy.”

Dr. Ana Carrera, Department of Endocrinology and Metabolism, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal


European Association for the Study of Obesity

2022-05-08 20:26:00

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