Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 5/2019

01-05-2019 | Sleeve Gastrectomy | Original Contributions

Timing of Gestation After Laparoscopic Sleeve Gastrectomy (LSG): Does It Influence Obstetrical and Neonatal Outcomes of Pregnancies?

Authors: Seda Sancak, Özgen Çeler, Elif Çırak, Aziz Bora Karip, M. Tumiçin Aydın, Nuriye Esen Bulut, M. Mahir Fersahoğlu, Hasan Altun, Kemal Memişoğlu

Published in: Obesity Surgery | Issue 5/2019

Login to get access

Abstract

Aim

We aimed to evaluate the effect of pregnancy timing after laparoscopic sleeve gastrectomy (LSG) on maternal and fetal outcomes.

Methods

Women with LSG were stratified into two groups with surgery-to-conception intervals of ≤ 18 months (early group) or > 18 months (late group). Only the first delivery after LSG was included in this study. We compared maternal characteristics, pregnancy, and neonatal outcomes and adherence to the Institute of Medicine’s (IOM) recommendations for gestational weight gain (GWG) in the two groups.

Results

Fifteen patients conceived ≤ 18 months after surgery, with a mean surgery-to-conception interval of 5.6 ± 4.12 months, and 29 women conceived > 18 months following LSG, with a mean surgery-to-conception interval of 32.31 ± 11.38 months, p < 0.05. There was no statistically significant difference between the two groups regarding birth weight, gestational age, cesarean deliveries (CD), preterm birth, whether their child was small or large for their gestational age, or in the need of neonatal intensive care. There was no correlation between mean weight loss from operation till conception, mean weight gain during pregnancy, and mean body mass index (BMI) at conception between birth weight in either study group. Inadequate and normal GWG was significantly higher in the early group, whereas excessive GWG was significantly higher in the late group (X2, 20.780; p = < 0.001).

Conclusion

The interval between LSG and conception did not impact maternal and neonatal outcomes. Pregnancy after LSG was overall safe and well-tolerated.
Literature
1.
WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. 2000.
2.
3.
Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169–80.CrossRefPubMedPubMedCentral
4.
Gundogan K, Bayram F, Gedik V, et al. Metabolic syndrome prevalence according to ATP III and IDF criteria and related factors in Turkish adults. Arch Med Sci. 2013;9(2):243–53.CrossRefPubMedPubMedCentral
5.
ACOG. Committee opinion number 315, September 2005. Obesity in pregnancy. Obstet Gynecol. 2005;106(3):671–5.CrossRef
6.
Costa MM, Belo S, Souteiro P, et al. Pregnancy after bariatric surgery: maternal and fetal outcomes of 39 pregnancies and a literature review. J Obstet Gynaecol Res. 2018;44(4):681–90.CrossRefPubMed
7.
Gastrointestinal Surgery for Severe Obesity. National Institutes of Health consensus development conference statement. Am J Clin Nutr. 1992;55:615S–9.CrossRef
8.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed
9.
Papamargaritis D, Koukoulis G, Sioka E, et al. Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(10):1600–6.CrossRefPubMed
10.
Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300(19):2286–96.CrossRefPubMed
11.
Kassir R, Goiset MP, Williet N, et al. Bariatric surgery and pregnancy: what outcomes? Int J Surg. 2016;36(Pt A):66–7.CrossRefPubMed
12.
Kwong W, Tomlinson G, Feig DS. Maternal and neonatal outcomes after bariatric surgery; a systematic review and meta-analysis: do the benefits outweigh the risks? Am J Obstet Gynecol. 2018;218(6):573–80.CrossRefPubMed
13.
Kjaer MM, Nilas L. Pregnancy after bariatric surgery--a review of benefits and risks. Acta Obstet Gynecol Scand. 2013;92(3):264–71.CrossRefPubMed
14.
Wax JR, Pinette MG, Cartin A, et al. Female reproductive issues following bariatric surgery. Obstet Gynecol Surv. 2007;62(9):595–604.CrossRefPubMed
15.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–13.CrossRef
16.
Friedman D, Cuneo S, Valenzano M, et al. Pregnancies in an 18-year follow-up after biliopancreatic diversion. Obes Surg. 1995;5(3):308–13.CrossRefPubMed
17.
Kjær MM, Nilas L. Timing of pregnancy after gastric bypass-a national register-based cohort study. Obes Surg. 2013;23(8):1281–5.CrossRefPubMed
18.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
19.
Mechanick JI, Youdim A, Jones DB, 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. Endocr Pract. 2013;19(2):337–72.CrossRefPubMedPubMedCentral
20.
Karmon A, Sheiner E. Timing of gestation after bariatric surgery: should women delay pregnancy for at least 1 postoperative year? Am J Perinatol. 2008;25(6):331–3.CrossRefPubMed
21.
Sheiner E, Edri A, Balaban E, et al. Pregnancy outcome of patients who conceive during or after the first year following bariatric surgery. Am J Obstet Gynecol. 2011;204(1):50.e1–6.CrossRef
22.
Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol. 2005;106(5 Pt 1):965–72.CrossRefPubMed
23.
Dao T, Kuhn J, Ehmer D, et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192(6):762–6.CrossRefPubMed
24.
Patel JA, Patel NA, Thomas RL, et al. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(1):39–45.CrossRefPubMed
25.
Wax JR, Cartin A, Wolff R, et al. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes Surg. 2008;18(12):1517–21.CrossRefPubMed
26.
González I, Rubio MA, Cordido F, et al. Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study. Obes Surg. 2015;25(3):436–42.CrossRefPubMed
27.
Harreiter J, Schindler K, Bancher-Todesca D, et al. Management of pregnant women after bariatric surgery. J Obes. 2018;2018:4587064. eCollection 2018. ReviewCrossRefPubMedPubMedCentral
28.
Basbug A, Ellibeş Kaya A, Dogan S, et al. Does pregnancy interval after laparoscopic sleeve gastrectomy affect maternal and perinatal outcomes? J Matern Fetal Neonatal Med. 2018;17:1–7.
29.
Stentebjerg LL, Andersen LLT, Renault K, et al. Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass. J Matern Fetal Neonatal Med. 2017;30(10):1182–8.CrossRefPubMed
30.
Rasteiro C, Araújo C, Cunha S, et al. Influence of time interval from bariatric surgery to conception on pregnancy and perinatal outcomes. Obes Surg. 2018;28(11):3559–66
31.
Nørgaard LN, Gjerris ACR, Kirkegaard I, et al. Fetal growth in pregnancies conceived after gastric bypass surgery in relation to surgery-to-conception interval: a Danish National Cohort Study. PLoS One. 2014;9(3):e90317.CrossRefPubMedPubMedCentral
32.
Ducarme G, Parisio L, Santulli P, et al. Neonatal outcomes in pregnancies after bariatric surgery: a retrospective multi-centric cohort study in three French referral centers. J Matern Fetal Neonatal Med. 2013;26(3):275–8.CrossRefPubMed
33.
Ducarme G, Chesnoy V, Lemarié P, et al. Pregnancy outcomes after laparoscopic sleeve gastrectomy among obese patients. Int J Gynaecol Obstet. 2015;130(2):127–31.CrossRefPubMed
34.
35.
Duran A, Sáenz S, Torrejón MJ, et al. Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study. Diabetes Care. 2014;37(9):2442–50.CrossRefPubMed
36.
Bebber FE, Rizzolli J, Casagrande DS, et al. Pregnancy after bariatric surgery: 39 pregnancies follow-up in a multidisciplinary team. Obes Surg. 2011;21(10):1546–51.CrossRefPubMed
37.
Kaska L, Kobiela J, Abacjew-Chmylko A, et al. Nutrition and pregnancy after bariatric surgery. ISRN Obes. 2013;2013:492060.PubMedPubMedCentral
38.
Aricha-Tamir B, Weintraub AY, Levi I, et al. Downsizing pregnancy complications: a study of paired pregnancy outcomes before and after bariatric surgery. Surg Obes Relat Dis. 2012;8(4):434–9.CrossRefPubMed
39.
Marceau P, Kaufman D, Biron S, et al. Outcome of pregnancies after biliopancreatic diversion. Obes Surg. 2004;14(3):318–24.CrossRefPubMed
40.
Parent B, Martopullo I, Weiss NS, et al. Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications. JAMA Surg. 2017;152(2):1–8.CrossRef
41.
Health statistics yearbook 2015. Nomenclature of territorial units for statistics and provinces. Republic of Turkey: Ministry of Health. 2015
42.
Yi XY, Li QF, Zhang J, et al. A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery. Int J Gynaecol Obstet. 2015;130(1):3–9.CrossRefPubMed
43.
Sheiner E, Levy A, Silverberg D, et al. Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. Am J Obstet Gynecol. 2004;190(5):1335–40.CrossRefPubMed
44.
Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91(3):436–40.CrossRefPubMedPubMedCentral
45.
American College of Obstetricians and Gynecologists. ACOG committee opinion no. 549: obesity in pregnancy. Obstet Gynecol. 2013;121:213–7.CrossRef
46.
Ducarme G, Revaux A, Rodrigues A, et al. Obstetric outcome following laparoscopic adjustable gastric banding. Int J Gynaecol Obstet. 2007;98(3):244–7.CrossRefPubMed
47.
Lapolla A, Marangon M, Dalfrà MG, et al. Pregnancy outcome in morbidly obese women before and after laparoscopic gastric banding. Obes Surg. 2010;20(9):1251–7.CrossRefPubMed
48.
Guelinckx I, Devlieger R, Vansant G. Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update. 2009;15(2):189–201.CrossRefPubMed
49.
Yau PO, Parikh M, Saunders JK, et al. Pregnancy after bariatric surgery: the effect of time-to-conception on pregnancy outcomes. Surg Obes Relat Dis. 2017;13(11):1899–905.CrossRefPubMed
50.
Dell'Agnolo CM, Cyr C, de Montigny F, et al. Pregnancy after bariatric surgery: obstetric and perinatal outcomes and the growth and development of children. Obes Surg. 2015;25(11):2030–9.CrossRefPubMed
51.
Olafsdottir AS, Skuladottir GV, Thorsdottir I, et al. Maternal diet in early and late pregnancy in relation to weight gain. Int J Obes. 2006;30(3):492–9.CrossRef
52.
Sjöström L, Narbro K, Sjöström CD. Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
Metadata
Title
Timing of Gestation After Laparoscopic Sleeve Gastrectomy (LSG): Does It Influence Obstetrical and Neonatal Outcomes of Pregnancies?
Authors
Seda Sancak
Özgen Çeler
Elif Çırak
Aziz Bora Karip
M. Tumiçin Aydın
Nuriye Esen Bulut
M. Mahir Fersahoğlu
Hasan Altun
Kemal Memişoğlu
Publication date
01-05-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-03700-8

Other articles of this Issue 5/2019

Obesity Surgery 5/2019 Go to the issue

Brief Communication

Acute Pancreatitis as a Complication of Intragastric Balloons: a Case Series

Original Contributions

Systematic Endoscopy 5 Years After Sleeve Gastrectomy Results in a High Rate of Barrett’s Esophagus: Results of a Multicenter Study

Brief Communication

Is Early Reimplantation of the Duodenal–Jejunal Bypass Liner Viable?

Letter to the Editor

Massive Gastrointestinal Bleeding Due to Splenic Artery Erosion by a PigTail Drain in a Post Sleeve Gastrectomy Leak: a Case Report

Original Contributions

Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group

Letter to the Editor

Bariatric Surgery in the Elderly Patient: Safety and Short-Time Outcome. A Case Match Analysis: Letter to the Editor