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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Review

Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome

Authors: Veronica Falcone, Tina Stopp, Michael Feichtinger, Herbert Kiss, Wolfgang Eppel, Peter Wolf Husslein, Gerhard Prager, Christian S. Göbl

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Bariatric surgery (BS) is regarded to be the most effective treatment of obesity with long lasting beneficial effects including weight loss and improvement of metabolic disorders. A considerable number of women undergoing BS are at childbearing age.
Although the surgery mediated weight loss has a positive effect on pregnancy outcome, the procedures might be associated with adverse outcomes as well, for example micronutrient deficiencies, iron or B12 deficiency anemia, dumping syndrome, surgical complications such as internal hernias, and small for gestational age (SGA) offspring, possibly due to maternal undernutrition. Also, there is no international consensus concerning the ideal time to conception after BS. Hence, the present narrative review intents to summarize the available literature concerning the most common challenges which arise before and during pregnancy after BS, such as fertility related considerations, vitamin and nutritional deficiencies and their adequate compensation through supplementation, altered glucose metabolism and its implications for gestational diabetes screening, the symptoms and treatment of dumping syndrome, surgical complications and the impact of BS on pregnancy outcome. The impact of different bariatric procedures on pregnancy and fetal outcome will also be discussed, as well as general considerations concerning the monitoring and management of pregnancies after BS.
Whereas BS leads to the mitigation of many obesity-related pregnancy complications, such as gestational diabetes mellitus (GDM), pregnancy induced hypertension and fetal macrosomia; those procedures pose new risks which might lead to adverse outcomes for mothers and offspring, for example nutritional deficiencies, anemia, altered maternal glucose metabolism and small for gestational age children.
Literature
1.
2.
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25, Part B):2985–3023.PubMedCrossRef
3.
Fried M, Yumuk V, Oppert JM, Scopinaro N, Torres A, Weiner R, et al. Interdisciplinary European guidelines on metabolic and Bariatric Surgery. Obes Surg. 2014;24(1):42–55.PubMedCrossRef
4.
5.
Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutrition Reviews. 2013;1:71(suppl_1):S18–25.
6.
Boots CE, Bernardi LA, Stephenson MD. Frequency of euploid miscarriage is increased in obese women with recurrent early pregnancy loss. Fertil Steril. 2014;102(2):455–9.PubMedCrossRef
7.
Stothard KJ, Tennant PWG, Bell R, Maternal Overweight RJ. Obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009;301(6):636–50.PubMedCrossRef
8.
Catalano PM. Hauguel-De Mouzon S. is it time to revisit the Pedersen hypothesis in the face of the obesity epidemic? Am J Obstet Gynecol. 2011;204(6):479–87.PubMedPubMedCentralCrossRef
9.
Best D, Avenell A, Bhattacharya S. How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence. Hum Reprod Update. 2017;23(6):681–705.PubMedCrossRef
10.
Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.
11.
Schauer PR, Nor Hanipah Z, Rubino F. Metabolic surgery for treating type 2 diabetes mellitus: now supported by the world’s leading diabetes organizations. Cleve Clin J Med. 2017;84(7 Suppl 1):S47–56.PubMedCrossRef
12.
Vest AR, Heneghan HM, Agarwal S, Schauer PR, Young JB. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart Br Card Soc. 2012;98(24):1763–77.
13.
Karason K, Wallentin I, Larsson B, Sjöström L. Effects of obesity and weight loss on cardiac function and valvular performance. Obes Res. 1998;6(6):422–9.PubMedCrossRef
14.
Russo V, Ammendola E, De Crescenzo I, Ricciardi D, Capuano P, Topatino A, et al. Effect of weight loss following bariatric surgery on myocardial dispersion of repolarization in morbidly obese patients. Obes Surg. 2007;17(7):857–65.PubMedCrossRef
15.
Elder KA, Wolfe BM. Bariatric surgery: a review of procedures and outcomes. Gastroenterology. 2007;132(6):2253–71.PubMedCrossRef
16.
Sullivan S, Edmundowicz SA, Endoscopic Bariatric TCC. Metabolic therapies: new and emerging technologies. Gastroenterology. 2017;152(7):1791–801.PubMedCrossRef
17.
Hill C, Khashab MA, Kalloo AN, Kumbhari V. Endoluminal weight loss and metabolic therapies: current and future techniques. Ann N Y Acad Sci. 2018;1411(1):36–52.PubMedCrossRef
18.
Crea N, Pata G, Della Casa D, Minelli L, Maifredi G, Di Betta E, et al. Improvement of metabolic syndrome following intragastric balloon: 1 year follow-up analysis. Obes Surg. 2009+;19(8):1084–8.PubMedCrossRef
19.
Musella M, Milone M, Bellini M, Fernandez MES, Fernandez LMS, Leongito M, et al. The potential role of intragastric balloon in the treatment of obese-related infertility: personal experience. Obes Surg. 2011;21(4):426–30.PubMedCrossRef
20.
Lesko J, Peaceman A. Pregnancy outcomes in women after Bariatric Surgery compared with obese and morbidly obese controls. Obstet Gynecol. 2012;119(3):547–54.PubMedCrossRef
21.
22.
Guelinckx I, Devlieger R, Vansant G. Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update. 2009;15(2):189–201.PubMedCrossRef
23.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–13.CrossRef
24.
Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, et al. Practical recommendations of the Obesity management task force of the European Association for the Study of Obesity for the post-Bariatric Surgery medical management. Obes Facts. 2018;10(6):597–632.CrossRef
25.
Kjær MM, Nilas L. Timing of pregnancy after gastric bypass-a national register-based cohort study. Obes Surg. 2013;23(8):1281–5.PubMedCrossRef
26.
Weng T-C, Chang C-H, Dong Y-H, Chang Y-C, Chuang L-M. Anaemia and related nutrient deficiencies after roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015;5(7):e006964.PubMedPubMedCentralCrossRef
27.
Via MA, Nutritional MJI. Micronutrient Care of Bariatric Surgery Patients: current evidence update. Curr Obes Rep. 2017;6(3):286–96.PubMedCrossRef
28.
Feichtinger M, Stopp T, Hofmann S, Springer S, Pils S, Kautzky-Willer A, et al. Altered glucose profiles and risk for hypoglycaemia during oral glucose tolerance testing in pregnancies after gastric bypass surgery. Diabetologia. 2017;60(1):153–7.PubMedCrossRef
29.
Johansson K, Cnattingius S, Näslund I, Roos N, Trolle Lagerros Y, Granath F, et al. Outcomes of pregnancy after bariatric surgery. N Engl J Med. 2015;372(9):814–24.PubMedCrossRef
30.
Vannevel V, Jans G, Bialecka M, Lannoo M, Devlieger R, Van Mieghem T. Internal herniation in pregnancy after gastric bypass: a systematic review. Obstet Gynecol. 2016;127(6):1013–20.PubMedCrossRef
31.
Renault K, Gyrtrup HJ, Damgaard K, Hedegaard M, Sørensen JL. Pregnant woman with fatal complication after laparoscopic roux-en-Y gastric bypass. Acta Obstet Gynecol Scand. 2012;91(7):873–5.PubMedCrossRef
32.
Moore KA, Ouyang DW, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. N Engl J Med. 2004;351(7):721–2.PubMedCrossRef
33.
Bellver J, Melo MAB, Bosch E, Serra V, Remohí J, Pellicer A. Obesity and poor reproductive outcome: the potential role of the endometrium. Fertil Steril. 2007;88(2):446–51.PubMedCrossRef
34.
Fedorcsák P, Dale PO, Storeng R, Ertzeid G, Bjercke S, Oldereid N, et al. Impact of overweight and underweight on assisted reproduction treatment. Hum Reprod. 2004;19(11):2523–8.PubMedCrossRef
35.
36.
Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev. 1996;17(2):121–55.PubMedCrossRef
37.
Nestler JE. Metformin for the treatment of the polycystic ovary syndrome. N Engl J Med. 2008;358(1):47–54.PubMedCrossRef
38.
Lim SS, Norman RJ, Davies MJ, Moran LJ. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev Off J Int Assoc Study Obes. 2013;14(2):95–109.CrossRef
39.
Provost MP, Acharya KS, Acharya CR, Yeh JS, Steward RG, Eaton JL, et al. Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry. Fertil Steril. 2016;105(3):663–9.PubMedCrossRef
40.
Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, et al. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22(6):687–708.PubMedCrossRef
41.
Escobar-Morreale HF, Santacruz E, Luque-Ramírez M, Botella Carretero JI. Prevalence of “obesity-associated gonadal dysfunction” in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis. Hum Reprod Update. 2017;23(4):390–408.PubMedCrossRef
42.
Milone M, De Placido G, Musella M, Sosa Fernandez LM, Sosa Fernandez LV, Campana G, et al. Incidence of successful pregnancy after weight loss interventions in infertile women: a systematic review and meta-analysis of the literature. Obes Surg. 2016;26(2):443–51.PubMedCrossRef
43.
Sarwer DB, Spitzer JC, Wadden TA, Mitchell JE, Lancaster K, Courcoulas A, et al. Changes in sexual functioning and sex hormone levels in women following bariatric surgery. JAMA Surg. 2014;149(1):26–33.PubMedCrossRef
44.
Milone M, Sosa Fernandez LM, Sosa Fernandez LV, Manigrasso M, Elmore U, De Palma GD, et al. Does Bariatric Surgery improve assisted Reproductive technology outcomes in obese infertile women? Obes Surg. 2017;27(8):2106–12.PubMedCrossRef
45.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 95: anemia in pregnancy. Obstet Gynecol. 2008;112(1):201–7.CrossRef
46.
Alwan N, Hamamy H. Maternal Iron status in pregnancy and long-term Health outcomes in the offspring. J Pediatr Genet. 2015;04(02):111–23.CrossRef
47.
48.
49.
Yanoff LB, Menzie CM, Denkinger B, Sebring NG, McHugh T, Remaley AT, et al. Inflammation and iron deficiency in the hypoferremia of obesity. Int J Obes. 2007;31(9):1412–9.CrossRef
50.
Tussing-Humphreys LM, Nemeth E, Fantuzzi G, Freels S, Holterman A-XL, Galvani C, et al. Decreased serum Hepcidin and improved functional Iron status 6 months after restrictive Bariatric Surgery. Obesity. 2010;18(10):2010–6.PubMedCrossRef
51.
Devlieger R, Guelinckx I, Jans G, Voets W, Vanholsbeke C, Micronutrient Levels VG. Supplement intake in pregnancy after Bariatric Surgery: a prospective cohort study. PLoS One. 2014;9(12):e114192.PubMedPubMedCentralCrossRef
52.
Galazis N, Docheva N, Simillis C, Nicolaides KH. Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014;181:45–53.PubMedCrossRef
53.
Nomura RMY, Dias MCG, Igai AMK, Paiva LV, Zugaib M. Anemia during pregnancy after Silastic ring roux-en-Y gastric bypass: influence of time to conception. Obes Surg. 2011;21(4):479–84.PubMedCrossRef
54.
Jans G, Matthys C, Bogaerts A, Lannoo M, Verhaeghe J, Van der Schueren B, et al. Maternal Micronutrient deficiencies and related adverse neonatal outcomes after Bariatric Surgery: a systematic review. Adv Nutr Int Rev J. 2015;6(4):420–9.CrossRef
55.
Allen LH. Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr. 2000;71(5):1280s–4s.PubMedCrossRef
56.
Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW, et al. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346(jun21 3):f3443.PubMedPubMedCentralCrossRef
57.
McArdle HJ, Gambling L, Kennedy C. Iron deficiency during pregnancy: the consequences for placental function and fetal outcome. Proc Nutr Soc. 2014;73(01):9–15.PubMedCrossRef
58.
59.
Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J, Still C. Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(11):4823–43.PubMedCrossRef
60.
Mechanick JI, Youdim A, Jones DB, Timothy Garvey W, Hurley DL, Molly McMahon M, et al. Clinical practice guidelines for the perioperative Nutritional, metabolic, and nonsurgical support of the Bariatric Surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–91.PubMedCrossRef
61.
Kaska L, Kobiela J, Abacjew-Chmylko A, Chmylko L, Wojanowska-Pindel M, Kobiela P, et al. Nutrition and pregnancy after Bariatric Surgery. ISRN Obes. 2013;2013:1–6.CrossRef
62.
Beard JH, Bell RL, Duffy AJ. Reproductive Considerations and Pregnancy after Bariatric Surgery: current evidence and recommendations. Obes Surg. 2008;18(8):1023–7.PubMedCrossRef
63.
Gascoin G, Gerard M, Sallé A, Becouarn G, Rouleau S, Sentilhes L, et al. Risk of low birth weight and micronutrient deficiencies in neonates from mothers after gastric bypass: a case control study. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2017;13(8):1384–91.CrossRef
64.
Faintuch J, Dias MCG, de Souza Fazio E, de Oliveira FCBM, Nomura RMY, Zugaib M, et al. Pregnancy Nutritional indices and birth weight after roux-en-Y gastric bypass. Obes Surg. 2009;19(5):583–9.PubMedCrossRef
65.
Lassi ZS, Salam RA, Haider BA, Bhutta ZA. Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes. In: Cochrane Database Syst Rev. John Wiley & Sons, Ltd; 2013 [cited 2017 Oct 20]. Available from: http://​onlinelibrary.​wiley.​com.​ez.​srv.​meduniwien.​ac.​at/​doi/​10.​1002/​14651858.​CD006896.​pub2/​abstract
66.
Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998 [cited 2017 Oct 20]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK114310/.
67.
Stein J, Stier C, Raab H, Weiner R. Review article: the nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther. 2014;40(6):582–609.PubMedCrossRef
68.
Rogne T, Tielemans MJ, Chong MF-F, Yajnik CS, Krishnaveni GV, Poston L, et al. Associations of Maternal Vitamin B12 concentration in pregnancy with the risks of preterm birth and low birth weight: a systematic review and meta-analysis of individual participant data. Am J Epidemiol. 2017;185(3):212–23.PubMed
69.
Finkelstein JL, Layden AJ, Stover PJ. Vitamin B-12 and perinatal Health. Adv Nutr Int Rev J. 2015;6(5):552–63.CrossRef
70.
Medeiros M, Matos AC, Pereira SE, Saboya C, Ramalho A, Vitamin D. Its relation with ionic calcium, parathyroid hormone, maternal and neonatal characteristics in pregnancy after roux-en-Y gastric bypass. Arch Gynecol Obstet. 2016;293(3):539–47.PubMedCrossRef
71.
Mousa A, Abell S, Scragg R, de Courten B. Vitamin D in Reproductive Health and Pregnancy. Semin Reprod Med. 2016;34(2):e1–13.PubMedCrossRef
72.
Moulas AN, Vaiou M. Vitamin D fortification of foods and prospective health outcomes. J. Biotechnol. 2018;10(285):91–101.
73.
Chen Y-H, Fu L, Hao J-H, Yu Z, Zhu P, Wang H, et al. Maternal vitamin D deficiency during pregnancy elevates the risks of small for gestational age and low birth weight infants in Chinese population. J Clin Endocrinol Metab. 2015;100(5):1912–9.PubMedCrossRef
74.
Wang H, Xiao Y, Zhang L, Gao Q. Maternal early pregnancy vitamin D status in relation to low birth weight and small-for-gestational-age offspring. J Steroid Biochem Mol Biol. 2018;175:146–50.PubMedCrossRef
75.
Lausten-Thomsen U, Olsen M, Greisen G, Schmiegelow K. Inflammatory markers in umbilical cord blood from small-for-gestational-age newborns. Fetal Pediatr Pathol. 2014;33(2):114–8.PubMedCrossRef
76.
Ko B-J, Myung SK, Cho K-H, Park YG, Kim SG, Kim DH, et al. Relationship between Bariatric Surgery and bone mineral density: a meta-analysis. Obes Surg. 2016;26(7):1414–21.PubMedCrossRef
77.
Wei J-H, Lee W-J, Chong K, Lee Y-C, Chen S-C, Huang P-H, et al. High incidence of secondary hyperparathyroidism in Bariatric patients: comparing different procedures. Obes Surg. 2018;28(3):798–804.PubMedCrossRef
78.
Grethen E, McClintock R, Gupta CE, Jones R, Cacucci BM, Diaz D, et al. Vitamin D and hyperparathyroidism in obesity. J Clin Endocrinol Metab. 2011;96(5):1320–6.PubMedPubMedCentralCrossRef
79.
80.
Faria SL, Faria OP, Buffington C, de Almeida Cardeal M, Ito MK. Dietary protein intake and bariatric surgery patients: a review. Obes Surg. 2011;21(11):1798–805.PubMedCrossRef
81.
de CP MT, Duarte TC, ERT M, de CF P, Marçola MA, De-Souza DA. Severe protein malnutrition in a morbidly obese patient after bariatric surgery. Nutr Burbank Los Angel Cty Calif. 2015;31(3):535–8.CrossRef
82.
Faintuch J, Matsuda M, Cruz MELF, Silva MM, Teivelis MP, Garrido AB, et al. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.PubMedCrossRef
83.
Schollenberger AE, Karschin J, Meile T, Küper MA, Königsrainer A, Bischoff SC. Impact of protein supplementation after bariatric surgery: a randomized controlled double-blind pilot study. Nutr Burbank Los Angel Cty Calif. 2016;32(2):186–92.CrossRef
84.
Kramer MS, Kakuma R. Energy and protein intake in pregnancy. Cochrane Database Syst Rev. 2003;4:CD000032.
85.
Hazart J, Le Guennec D, Accoceberry M, Lemery D, Mulliez A, Farigon N, et al. Maternal Nutritional deficiencies and small-for-gestational-age neonates at birth of women who have undergone Bariatric Surgery. J Pregnancy. 2017;2017:4168541.PubMedPubMedCentralCrossRef
86.
McCauley ME, van den Broek N, Dou L, Othman M. Vitamin a supplementation during pregnancy for maternal and newborn outcomes. Cochrane Database Syst Rev 2015;(10):CD008666.
87.
Strobel M, Tinz J, Biesalski H-K. The importance of β-carotene as a source of vitamin a with special regard to pregnant and breastfeeding women. Eur J Nutr. 2007;46(1):1–20.CrossRef
88.
Association AD. 2. Classification and Diagnosis of Diabetes: Standards of medical Care in Diabetes—2018. Diabetes Care. 2018;41(Supplement 1):S13–27.CrossRef
89.
90.
Weinert LS. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Diabetes Care. 2010;33(7):e97 author reply e98.PubMedCrossRef
91.
Wendland EM, Torloni MR, Falavigna M, Trujillo J, Dode MA, Campos MA, et al. Gestational diabetes and pregnancy outcomes--a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in pregnancy study groups (IADPSG) diagnostic criteria. BMC Pregnancy Childbirth. 2012;12:23.PubMedPubMedCentralCrossRef
92.
Torloni MR, Betrán AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009;10(2):194–203.PubMedCrossRef
93.
Lekva T, Norwitz ER, Aukrust P, Ueland T. Impact of systemic inflammation on the progression of gestational diabetes mellitus. Curr Diab Rep. 2016;16(4):26.PubMedCrossRef
94.
95.
Scholl TO, Sowers M, Chen X, Lenders C. Maternal glucose concentration influences fetal growth, gestation, and Pregnancy Complications. Am J Epidemiol. 2001;154(6):514–20.PubMedCrossRef
96.
Fetita L-S, Sobngwi E, Serradas P, Calvo F, Gautier J-F. Consequences of fetal exposure to Maternal diabetes in offspring. J Clin Endocrinol Metab. 2006;91(10):3718–24.PubMedCrossRef
97.
Hillier TA, Pedula KL, Schmidt MM, Mullen JA, Charles M-A, Pettitt DJ. Childhood Obesity and Metabolic imprinting: the ongoing effects of maternal hyperglycemia. Diabetes Care. 2007;30(9):2287–92.PubMedCrossRef
98.
Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300(19):2286–96.PubMedCrossRef
99.
Vrebosch L, Bel S, Vansant G, Guelinckx I, Devlieger R. Maternal and Neonatal outcome after laparoscopic adjustable gastric banding: a systematic review. Obes Surg. 2012;22(10):1568–79.PubMedCrossRef
100.
Magdaleno R, Pereira BG, Chaim EA, Turato ER. Pregnancy after bariatric surgery: a current view of maternal. obstetrical and perinatal challenges Arch Gynecol Obstet. 2012;285(3):559–66.PubMedCrossRef
101.
Sheiner E, Willis K, Bariatric Surgery YY. Impact on pregnancy outcomes. Curr Diab Rep. 2013;13(1):19–26.PubMedCrossRef
102.
Yi X, Li Q, Zhang J. Wang Z. a meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery. Int J Gynecol Obstet. 2015;130(1):3–9.CrossRef
103.
Goldfine AB, Mun EC, Devine E, Bernier R, Baz-Hecht M, Jones DB, et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab. 2007 Dec;92(12):4678–85.PubMedCrossRef
104.
Göbl CS, Bozkurt L, Tura A, Leutner M, Andrei L, Fahr L, et al. Assessment of glucose regulation in pregnancy after gastric bypass surgery. Diabetologia. 2017;60(12):2504–13.PubMedCrossRefPubMedCentral
105.
Adam S, Ammori B, Soran H, Syed AA. Pregnancy after bariatric surgery: screening for gestational diabetes. BMJ. 2017;356:j533.PubMedCrossRef
106.
Bonis C, Lorenzini F, Bertrand M, Parant O, Gourdy P, Vaurs C, et al. Glucose profiles in pregnant women after a gastric Bypass : findings from continuous glucose monitoring. Obes Surg. 2016;26(9):2150–5.PubMedCrossRef
107.
108.
Rariy CM, Rometo D, Korytkowski M. Post–gastric bypass hypoglycemia. Curr Diab Rep. 2016;16(2):19.PubMedCrossRef
109.
Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens Int J Womens Cardiovasc Health. 2014;4(2):97–104.
110.
111.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.PubMedCrossRef
112.
Fingar KR, Mabry-Hernandez I, Ngo-Metzger Q, Wolff T, Steiner CA, Elixhauser A. Delivery Hospitalizations Involving Preeclampsia and Eclampsia, 2005–2014: Statistical Brief #222. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 [cited 2017 Oct 17]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK442039/​
113.
Mbah A, Kornosky J, Kristensen S, August E, Alio A, Marty P, et al. Super-obesity and risk for early and late pre-eclampsia. BJOG Int J Obstet Gynaecol. 2010;117(8):997–1004.CrossRef
114.
Spradley FT. Metabolic abnormalities and obesity’s impact on the risk for developing preeclampsia. Am J Physiol - Regul Integr Comp Physiol. 2017;312(1):R5–12.PubMedCrossRef
115.
Spradley FT, Palei AC, Granger JP. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. Am J Physiol - Regul Integr Comp Physiol. 2015;309(11):R1326–43.PubMedPubMedCentralCrossRef
116.
Bennett WL, Gilson MM, Jamshidi R, Burke AE, Segal JB, Steele KE, et al. Impact of bariatric surgery on hypertensive disorders in pregnancy: retrospective analysis of insurance claims data. BMJ. 2010;13(340):c1662.
117.
González I, Lecube A, Rubio MÁ, García-Luna PP. Pregnancy after bariatric surgery: improving outcomes for mother and child. Int J Womens Health. 2016;8:721–9.PubMedPubMedCentralCrossRef
118.
Ducarme G, Revaux A, Rodrigues A, Aissaoui F, Pharisien I, Uzan M. Obstetric outcome following laparoscopic adjustable gastric banding. Int J Gynecol Obstet. 2007;98(3):244–7.CrossRef
119.
Petersen L, Lauenborg J, Svare J, Nilas L. The impact of upper abdominal pain during pregnancy following a gastric bypass. Obes Surg. 2017;27(3):688–93.PubMedCrossRef
120.
Leal-González R. De la Garza-Ramos R, Guajardo-Pérez H, Ayala-Aguilera F, Rumbaut R. internal hernias in pregnant women with history of gastric bypass surgery: case series and review of literature. Int J Surg Case Rep. 2013;4(1):44–7.PubMedCrossRef
121.
Baba A, Yamazoe S, Dogru M, Okuyama Y, Mogami T, Kobashi Y, et al. Petersen hernia after open gastrectomy with roux-en-Y reconstruction: a report of two cases and literature review. Springerplus. 2015;4:753.PubMedPubMedCentralCrossRef
122.
Gudbrand C, Andreasen LA, Boilesen AE. Internal hernia in pregnant women after gastric bypass: a retrospective register-based cohort study. Obes Surg. 2015;25(12):2257–62.PubMedCrossRef
123.
Correa A, Marcinkevage J. Prepregnancy obesity and the risk of birth defects: an update. Nutr Rev. 2013;71(Suppl 1):S68–77.PubMedCrossRef
124.
125.
Tsur A, Sergienko R, Wiznitzer A, Zlotnik A, Sheiner E. Critical analysis of risk factors for shoulder dystocia. Arch Gynecol Obstet. 2012;285(5):1225–9.PubMedCrossRef
126.
Simeoni U, Barker DJ. Offspring of diabetic pregnancy: long-term outcomes. Semin Fetal Neonatal Med. 2009;14(2):119–24.PubMedCrossRef
127.
Bienstock JL, Holcroft CJ, Althaus J. Small fetal abdominal circumference in the second trimester and subsequent low maternal plasma glucose after a glucose challenge test is associated with the delivery of a small-for-gestational age neonate. Ultrasound Obstet Gynecol. 2008;31(5):517–9.PubMedCrossRef
128.
Levy-Marchal C, Jaquet D. Long-term metabolic consequences of being born small for gestational age. Pediatr Diabetes. 2004;5(3):147–53.PubMedCrossRef
129.
Fernandez-Twinn DS, Ozanne SE. Mechanisms by which poor early growth programs type-2 diabetes, obesity and the metabolic syndrome. Physiol Behav. 2006;88(3):234–43.PubMedCrossRef
130.
Sheiner E, Balaban E, Dreiher J, Levi I, Levy A. Pregnancy outcome in patients following different types of bariatric surgeries. Obes Surg. 2009;19(9):1286–92.PubMedCrossRef
131.
Ducarme G, Parisio L, Santulli P, Carbillon L, Mandelbrot L, Luton D. Neonatal outcomes in pregnancies after bariatric surgery: a retrospective multi-centric cohort study in three French referral centers. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2013;26(3):275–8.
132.
Martin CR, Ling P-R, Blackburn GL. Review of infant feeding: key features of breast Milk and infant formula. Nutrients. 2016;8(5).
133.
Grange DK, Finlay JL. Nutritional vitamin B12 deficiency in a breastfed infant following maternal gastric bypass. Pediatr Hematol Oncol. 1994;11(3):311–8.PubMedCrossRef
134.
Martens WS, Martin LF, Berlin CM. Failure of a nursing infant to thrive after the mother’s gastric bypass for morbid obesity. Pediatrics. 1990;86(5):777–8.PubMed
135.
Salone LR, Vann WF, Dee DL. Breastfeeding: an overview of oral and general health benefits. J Am Dent Assoc 1939. 2013;144(2):143–51.CrossRef
136.
Isaacs EB, Fischl BR, Quinn BT, Chong WK, Gadian DG, Lucas A. Impact of breast milk on intelligence quotient, brain size, and white matter development. Pediatr Res. 2010;67(4):357–62.PubMedPubMedCentralCrossRef
137.
Aguilar Cordero MJ, Sánchez López AM, Madrid Baños N, Mur Villar N, Expósito Ruiz M, Hermoso RE. Breastfeeding for the prevention of overweight and obesity in children and teenagers; systematic review. Nutr Hosp. 2014;31(2):606–20.PubMed
138.
Jans G, Devlieger R, De Preter V, Ameye L, Roelens K, Lannoo M, et al. Bariatric Surgery does not appear to affect Women’s breast-Milk composition. J Nutr. 2018;148(7):1096–102.PubMed
139.
Chevrot A, Kayem G, Coupaye M, Lesage N, Msika S, Mandelbrot L. Impact of bariatric surgery on fetal growth restriction: experience of a perinatal and bariatric surgery center. Am J Obstet Gynecol 2016;214(5):655.e1–7.
Metadata
Title
Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome
Authors
Veronica Falcone
Tina Stopp
Michael Feichtinger
Herbert Kiss
Wolfgang Eppel
Peter Wolf Husslein
Gerhard Prager
Christian S. Göbl
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-2124-3

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