SFEEU2017 Obesity Update Oral Communications (8 abstracts)
Pregnancy after bariatric surgery: a single-centre retrospective cohort study
Janine Makaronidis 1 , Andrea Pucci 1 , Sean Manning 1 , Wui Hang Cheung 1 , Helen Kingett 2 , Grainne Buckley 2 , Amy Kirk 2 , Kayon Carr-Rose 2 , Anita Tshiala 2 , Andrew Jenkinson 2 , Mohamed Elkalaawy 2 , Majid Hashemi 2 , Marco Adamo 2 , Pat O’Brien 2 , Yana Richens 2 & Rachel Batterham 1
1Centre for Obesity Research, Division of Medicine, Rayne Institute, University College London, London, UK; 2University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK.
Background: The number of women seeking bariatric surgery in order to improve their fertility is increasing. Current guidelines recommend that pregnancy should be delayed for at least 1 year post-surgery. However, there are limited data regarding pregnancy outcomes post-surgery, particularly for sleeve gastrectomy.
Methods: We performed a single-centre, retrospective cohort study of pregnancies in women post-bariatric surgery. Surgical and maternity records were reviewed and maternal and fetal outcomes examined.
Results: Ninety-seven pregnancies in 69 women were documented over an 8-year period. Forty-one women had undergone a Roux-en-Y gastric bypass and 28 a sleeve gastrectomy. There were 79 pregnancies with a known outcome; 18 women were lost to follow-up during pregnancy. 32.9% of pregnancies occurred in the first post-operative year. Pregnancies conceived in the first post-operative year were associated with a higher miscarriage rate compared to pregnancies after this time (50% vs 30.4%, P<0.05). A pre-conception body mass index (BMI) of >35 kg/m2 also associated with an increased miscarriage rate (22.8% vs 50%, P<0.05). Caesarean sections rates were similar in pregnancies conceived before or after the first post-operative year and in women with a BMI higher or lower than >35 kg/m2. During pregnancy, two women developed gestational diabetes (1.9%) and there were no cases of gestational hypertension. Three women had a post-partum haemorrhage (2.9%). With regards to fetal outcomes, mean birth weight was 3.11±0.1 kg and mean gestational age at birth 39.5±0.4 weeks. Birth weight was not affected by duration from surgery or pre-conception BMI. There were two cases of severe fetal developmental abnormalities. Intrauterine growth restriction was seen in two pregnancies, both in the same woman.
Conclusion: Our data support current recommendations to delay conception until 1 year after surgery, however larger data collections are required to build a robust evidence base and allow guideline development.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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