Endocrine Abstracts

Obesity increases the risk of pregnancy-related complications such as miscarriage, foetal abnormalities, hypertension, diabetes, thrombosis, caesarean section and infection. Although bariatric surgery addresses some of these risks, women should defer pregnancy for 12-24 months postoperatively until weight loss has plateaued due to concerns regarding limited maternal weight loss and foetal nutritional deficiency. The aim of this study was to evaluate the impact of pregnancy on weight loss after bariatric surgery and to assess pregnancy outcomes.

Amongst 730 obese people who underwent bariatric surgery, 232 women of childbearing age (18–45 years) with a mean ± S.D. age 34.0±5.9 years, preoperative weight 137.7±21.3 kg and BMI 50.6±7.2 kg/m² were identified. One-hundred and ninety-seven women (84.9%) had undergone Roux-en-Y gastric bypass, 19 (8.2%) adjustable gastric banding, 8 (3.4%) sleeve gastrectomy and 8 (3.4%) other procedures.

Women who became pregnant following bariatric surgery (n=21) were younger at the time of surgery compared to women in the non-pregnancy group (28.0±5.4

vs 34.6±5.6 years, P <0.001) but were otherwise well matched for preoperative weight (136.5±18.5 vs 137.8±21.6 kg), BMI (49.2±7.4 vs 50.7±7.2 kg/m²) and type of bariatric procedure.

Eighteen women (86%) completed pregnancy successfully; 12 (57%) had live births by vaginal route, 6 (29%) had caesarean section; 2 (9%) undertook medical termination of pregnancy and 1 (5%) suffered a spontaneous miscarriage.

At a median follow-up of 30 months, the pregnancy and non-pregnancy groups achieved significant but comparable excess weight loss after bariatric surgery (70.4 vs 70.0%).

In conclusion, pregnancy after bariatric surgery is safe and does not adversely influence weight loss outcomes. However, close surveillance of maternal weight and nutritional status is advisable, especially with conception within the first 12 months after surgery.