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Pregnancy Following Bariatric Surgery

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Maternal Obesity and Pregnancy

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Abstract

Bariatric surgery such as the laparoscopic adjustable gastric-banding or Roux-en-Y gastric bypass is an effective treatment for morbid obesity. Parallel to the increasing prevalence of obesity, the number of performed bariatric operations is increasing. The predominant part of the patients for this type of surgery are women of reproductive age. Health-care providers will therefore increasingly be confronted with pregnant women with a history of gastric surgery. The impact of this surgery on fertility, pregnancy and neonatal outcome is discussed in the book chapter, as well as the potential mechanic complications and nutritional deficiencies due to the surgery. This high-risk subpopulation of pregnant women should be guided by a multidisciplinary team. The recommendations made at the end of the chapter can assist the team in the clinical guidance during the preconceptional, prenatal, and postpartum period.

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Abbreviations

BMI:

Body mass index

FSH:

Follicular stimulating hormone

GnRH:

Gonadotropin releasing hormone

LAGB:

Laparoscopic adjustable gastric band

LH:

Luteinizing hormone

MIS:

Müllerian inhibiting substance

RYGB:

Roux-en-Y gastric bypass

SHBG:

Sex hormone–binding globuline

SD:

Standard deviation

References

  • Aasheim ET (2008) Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg 248(5):714–720

    PubMed  Google Scholar 

  • Aasheim ET, Hofso D, Hjelmesaeth J et al (2008) Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 87(2):362–369

    PubMed  CAS  Google Scholar 

  • Adami GF, Friedman D, Cuneo S et al (1992) Intravenous nutritional support in pregnancy. Experience following biliopancreatic diversion. Clin Nutr 11(2):106–109

    Article  PubMed  CAS  Google Scholar 

  • Almhanna K, Khan P, Schaldenbrand M et al (2006) Sideroblastic anemia after bariatric surgery. Am J Hematol 81(2):155–156

    Article  PubMed  Google Scholar 

  • Ashourian N, Mousdicas N (2006) Images in clinical medicine. Pellagra-like dermatitis. N Engl J Med 354(15):1614

    Article  PubMed  CAS  Google Scholar 

  • Avinoah E, Ovnat A, Charuzi I (1992) Nutritional status seven years after Roux-en-Y gastric bypass surgery. Surgery 111(2):137–142

    PubMed  CAS  Google Scholar 

  • Bal BS, Finelli FC, Koch TR (2011) Origins of and recognition of micronutrient deficiencies after gastric bypass surgery. Curr Diab Rep 11(2):136–141

    Article  PubMed  Google Scholar 

  • Buchwald H (2005) Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis 1(3):371–381

    Article  PubMed  Google Scholar 

  • Buchwald H, Oien DM (2009) Metabolic/bariatric surgery worldwide 2008. Obes Surg 19(12):1605–1611

    Article  PubMed  Google Scholar 

  • Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292(14):1724–1737

    Article  PubMed  CAS  Google Scholar 

  • Bult MJ, van Dalen T, Muller AF (2008) Surgical treatment of obesity. Eur J Endocrinol 158(2):135–145

    Article  PubMed  CAS  Google Scholar 

  • Celiker MY, Chawla A (2009) Congenital B12 deficiency following maternal gastric bypass. J Perinatol 29(9):640–642

    Article  PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention (2010) CDC Grand Rounds: additional opportunities to prevent neural tube defects with folic acid fortification. MMWR Morb Mortal Wkly Rep 59(31):980–984

    Google Scholar 

  • Coates PS, Fernstrom JD, Fernstrom MH et al (2004) Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab 89(3):1061–1065

    Article  PubMed  CAS  Google Scholar 

  • Cools M, Duval EL, Jespers A (2006) Adverse neonatal outcome after maternal biliopancreatic diversion operation: report of nine cases. Eur J Pediatr 165(3):199–202

    Article  PubMed  Google Scholar 

  • Dao T, Kuhn J, Ehmer D et al (2006) Pregnancy outcomes after gastric-bypass surgery. Am J Surg 192(6):762–766

    Article  PubMed  Google Scholar 

  • di Frega AS, Dale B, Di Matteo L et al (2005) Secondary male factor infertility after Roux-en-Y gastric bypass for morbid obesity: case report. Hum Reprod 20(4):997–998

    Article  PubMed  Google Scholar 

  • Dixon JB, Dixon ME, O’Brien PE (2001) Elevated homocysteine levels with weight loss after Lap-Band surgery: higher folate and vitamin B12 levels required to maintain homocysteine level. Int J Obes Relat Metab Disord 25(2):219–227

    Article  PubMed  CAS  Google Scholar 

  • Dixon JB, Dixon ME, O’Brien PE (2005) Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 106(5 Pt 1):965–972

    Article  PubMed  Google Scholar 

  • Eerdekens A, Debeer A, Van Hoey G et al (2009) Maternal bariatric surgery: adverse outcomes in neonates. Eur J Pediatr 169(2):191–196

    Article  PubMed  Google Scholar 

  • Friedman D, Cuneo S, Valenzano M et al (1995) Pregnancies in an 18-year follow-up after biliopancreatic diversion. Obes Surg 5(3):308–313

    Article  PubMed  Google Scholar 

  • Gaudry P, Mognol P, Fortin A et al (2006) Reflection on one case of acute peritonitis due to adjustable gastric banding during pregnancy. Gynecol Obstet Fertil 34(5):407–409

    Article  PubMed  CAS  Google Scholar 

  • Granstrom L, Granstrom L, Backman L (1990) Fetal growth retardation after gastric banding. Acta Obstet Gynecol Scand 69(6):533–536

    Article  PubMed  CAS  Google Scholar 

  • Guelinckx I, Devlieger R, Vansant G (2009) Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update 15(2):189–201

    Article  PubMed  Google Scholar 

  • Gurewitsch ED, Smith-Levitin M, Mack J (1996) Pregnancy following gastric bypass surgery for morbid obesity. Obstet Gynecol 88(4 Pt 2):658–661

    Article  PubMed  CAS  Google Scholar 

  • Hammoud A, Gibson M, Hunt SC et al (2009) Effect of Roux-en-Y gastric bypass surgery on the sex steroids and quality of life in obese men. J Clin Endocrinol Metab 94(4):1329–1332

    Article  PubMed  CAS  Google Scholar 

  • Haward RN, Brown WA, O’Brien PE (2011) Does pregnancy increase the need for revisional surgery after laparoscopic adjustable gastric banding? Obes Surg 21:1362–1369

    Article  PubMed  Google Scholar 

  • Institute of Medicine (IOM) (2009) Weight gain during pregnancy: reexamining the guidelines. The National Academies Press, Washington, DC

    Google Scholar 

  • Kakarla N, Dailey C, Marino T et al (2005) Pregnancy after gastric bypass surgery and internal hernia formation. Obstet Gynecol 105(5 Pt 2):1195–1198

    Article  PubMed  Google Scholar 

  • Livingston EH (2002) Obesity and its surgical management. Am J Surg 184(2):103–113

    Article  PubMed  Google Scholar 

  • Maggard MA, Yermilov I, Li Z et al (2008) Pregnancy and fertility following bariatric surgery: a systematic review. JAMA 300(19):2286–2296

    Article  PubMed  CAS  Google Scholar 

  • Marceau P, Kaufman D, Biron S et al (2004) Outcome of pregnancies after biliopancreatic diversion. Obes Surg 14(3):318–324

    Article  PubMed  Google Scholar 

  • Merhi ZO (2009) Impact of bariatric surgery on female reproduction. Fertil Steril 92(5):1501–1508

    Article  PubMed  Google Scholar 

  • Merhi ZO, Pal L (2007) Effect of weight loss by bariatric surgery on the risk of miscarriage. Gynecol Obstet Invest 64(4):224–227

    PubMed  Google Scholar 

  • Nomura RM, Dias MC, Igai AM et al (2011) Anemia during pregnancy after silastic ring Roux-en-Y gastric bypass: influence of time to conception. Obes Surg 21(4):479–484

    Article  PubMed  Google Scholar 

  • Patel JA, Patel NA, Thomas RL et al (2008) Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 4(1):39–45

    Article  PubMed  Google Scholar 

  • Paulen ME, Zapata LB, Cansino C et al (2010) Contraceptive use among women with a history of bariatric surgery: a systematic review. Contraception 82(1):86–94

    Article  PubMed  Google Scholar 

  • Picot J, Jones J, Colquitt JL et al (2009) The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess 13(41):1–190, 215–357, iii-iv

    CAS  Google Scholar 

  • Poitou Bernert C, Ciangura C, Coupaye M et al (2007) Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment. Diabetes Metab 33(1):13–24

    Article  PubMed  CAS  Google Scholar 

  • Printen KJ, Scott D (1982) Pregnancy following gastric bypass for the treatment of morbid obesity. Am Surg 48(8):363–365

    PubMed  CAS  Google Scholar 

  • Roehrig HR, Xanthakos SA, Sweeney J et al (2007) Pregnancy after gastric bypass surgery in adolescents. Obes Surg 17(7):873–877

    Article  PubMed  Google Scholar 

  • Samuel I, Mason EE, Renquist KE et al (2006) Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg 192(5):657–662

    Article  PubMed  Google Scholar 

  • Schilling PL, Davis MM, Albanese CT et al (2008) National trends in adolescent bariatric surgical procedures and implications for surgical centers of excellence. J Am Coll Surg 206(1):1–12

    Article  PubMed  Google Scholar 

  • Shah DK, Ginsburg ES (2010) Bariatric surgery and fertility. Curr Opin Obstet Gynecol 22(3):248–254

    Article  PubMed  Google Scholar 

  • Shankar P, Boylan M, Sriram K (2010) Micronutrient deficiencies after bariatric surgery. Nutrition 26(11–12):1031–1037

    Article  PubMed  CAS  Google Scholar 

  • Sheiner E, Levy A, Silverberg D et al (2004) Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Am J Obstet Gynecol 190(5):1335–1340

    Article  PubMed  Google Scholar 

  • Sheiner E, Edri A, Balaban E et al (2011) Pregnancy outcome of patients who conceive during or after the first year following bariatric surgery. Am J Obstet Gynecol 204(1):50e1–56e1

    Article  Google Scholar 

  • Smets KJ, Barlow T, Vanhaesebrouck P (2006) Maternal vitamin A deficiency and neonatal microphthalmia: complications of biliopancreatic diversion? Eur J Pediatr 165(7):502–504

    Article  PubMed  Google Scholar 

  • Smith J, Cianflone K, Biron S et al (2009) Effects of maternal surgical weight loss in mothers on intergenerational transmission of obesity. J Clin Endocrinol Metab 94(11):4275–4283

    Article  PubMed  CAS  Google Scholar 

  • Stocker DJ (2003) Management of the bariatric surgery patient. Endocrinol Metab Clin North Am 32(2):437–457

    Article  PubMed  Google Scholar 

  • Teitelman M, Grotegut CA, Williams NN et al (2006) The impact of bariatric surgery on menstrual patterns. Obes Surg 16(11):1457–1463

    Article  PubMed  Google Scholar 

  • Tucker ON, Szomstein S, Rosenthal RJ (2007) Nutritional consequences of weight-loss surgery. Med Clin North Am 91(3):499–514, xii

    Article  PubMed  CAS  Google Scholar 

  • Wardinsky TD, Montes RG, Friederich RL et al (1995) Vitamin B12 deficiency associated with low breast-milk vitamin B12 concentration in an infant following maternal gastric bypass surgery. Arch Pediatr Adolesc Med 149(11):1281–1284

    Article  PubMed  CAS  Google Scholar 

  • Wax JR, Wolff R, Cobean R et al (2007a) Intussusception complicating pregnancy following laparoscopic Roux-en-Y gastric bypass. Obes Surg 17(7):977–979

    Article  PubMed  Google Scholar 

  • Wax JR, Heersink D, Pinette MG et al (2007b) Symptomatic hypoglycemia complicating pregnancy following Roux-en-Y gastric bypass surgery. Obes Surg 17(5):698–700

    Article  PubMed  Google Scholar 

  • Wax JR, Cartin A, Wolff R et al (2008) Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes Surg 18(12):1517–1521

    Article  PubMed  Google Scholar 

  • Weintraub AY, Levy A, Levi I et al (2008) Effect of bariatric surgery on pregnancy outcome. Int J Gynaecol Obstet 103(3):246–251

    Article  PubMed  Google Scholar 

  • Weissman A, Hagay Z, Schachter M et al (1995) Severe maternal and fetal electrolyte imbalance in pregnancy after gastric surgery for morbid obesity. A case report. J Reprod Med 40(11):813–816

    PubMed  CAS  Google Scholar 

  • World Health Organisation (2006) Overweight and obesity. Factsheet no.311, World Health Organization, Geneva

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nutrition-Public Health Medicine, Catholic University Leuven, Kapucijnenvoer 35, 7001B-3000, Leuven, Belgium

    Isabelle Guelinckx Ph.D., M.Sc & Greet Vansant Ph.D., ir

  2. Department of Obstetrics and Gynaecology, University Hospital Leuven, Leuven, Belgium

    Roland Devlieger M.D., Ph.D.

Authors
  1. Isabelle Guelinckx Ph.D., M.Sc
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  2. Roland Devlieger M.D., Ph.D.
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  3. Greet Vansant Ph.D., ir
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Corresponding author

Correspondence to Isabelle Guelinckx Ph.D., M.Sc .

Editor information

Editors and Affiliations

  1. , Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 1, Aarhus N, 8200, Denmark

    Per Glud Ovesen

  2. , Department of Endocrinology, Odense University Hospital, Kløvervænget 6, Odense C, 5000, Denmark

    Dorte Møller Jensen

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Guelinckx, I., Devlieger, R., Vansant, G. (2012). Pregnancy Following Bariatric Surgery. In: Ovesen, P., Møller Jensen, D. (eds) Maternal Obesity and Pregnancy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25023-1_19

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  • DOI: https://doi.org/10.1007/978-3-642-25023-1_19

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