A Retrospective Evaluation of Pregnancy Outcomes Following Bariatric Surgery: A Single-Center Experience

Figures & data

Table 1 Changes in Weight and BMI Before BMS, During Pregnancy After BMS, and After Delivery

Observation Time and Parameter	Mean ±S.D./Median (P25, P75)	Range
Prepregnancy Characteristics
Pre-operation weight (kg)	92.60 (85.70, 110.30)	77.00–137.70
Pre-operation BMI (kg/m^2)	36.65 ± 5.45	28.61–49.32
Age at the time of operation (years)	29.39 ± 3.85	22.00–40.00
Types of BMS, n (%)
LSG	18 (58.06)
LRYGB	13 (41.94)
Weight and BMI Changes after BMS
Weight 1 month post operation (kg)	82.50 (76.30, 93.40)	70–123.30
BMI 1 month post operation (kg/m^2)	32.42 ± 4.69	25.81–44.16
Weight loss within 1 month post operation (kg)	11.25 ± 3.96	4.00–22.30
Weight 6 months post operation (kg)	73.13 ± 14.32	53.00–110.00
BMI 6 months post operation (kg/m^2)	27.35 ± 4.81	19.19–39.39
Weight loss within 6 months post operation (kg)	24.76 ± 8.40	10.00–47.00
Pregnancy Characteristics
Weight at conception (kg)	65.00 (61.00, 82.00)	50.00–150.00
BMI at conception (kg/m^2)	25.67 (22.44, 31.60)	18.51–55.10
Weight during 3rd trimester (kg)	78.00 (73.38, 95.50)	57.00–180.00
Weight gain during pregnancy (kg)	13.08 ± 5.98	3.00–30.00
Postpartum Characteristics
Weight post delivery (kg)	71.00 (62.00, 89.25)	55.00–170.00
Weight 1 year post delivery (kg)	70.50 (60.00, 87.00)	51.00–190.00
BMI 1 year post delivery (kg/m^2)	27.17 (23.91, 30.02)	18.87–69.79
Current weight (Dec.-2021) (kg)	72.50 (64.00, 84.00)	50.00–190.00
Current BMI (Dec.-2021) (kg/m^2)	27.38 (24.22, 30.09)	18.59–69.79
Duration for delivery from DoS (months)	24.00 (12.00, 36.00)	5.00–84.00

Note: Data are presented as mean ± S.D. or median (P25, P75) or numbers (percentages).

Abbreviations: BMI, body mass index; BMS, bariatric and metabolic surgery; DoS, date of surgery; LRYGB, laparoscopic Roux-en-Y gastric bypass; LSG, laparoscopic sleeve gastrectomy; S.D., standard deviation.

Figure 1 Changes of body weight and BMI in various periods. (A) Body weight of all patients before and post operation (n = 31); (B) BMI of all patients before and post operation (n = 31); (C) body weight of patients with successful delivery in different periods (n = 18); (D) BMI of patients with successful delivery in different periods (n = 18). *P < 0.05, **P < 0.01, ***P < 0.001.

Table 2 Menstrual Changes Before and Post Operation

	Regular Menstruation	Irregular Menstruation	P
Group			0.000^c,***
Before operation, n (%)	14 (45.16)	17 (54.84)
Post operation, n (%)	25 (80.65)	6 (19.35)

Notes: Data are presented as numbers (percentages). ^cFisher’s exact test. ***P < 0.001.

Table 3 Obesity-Related Comorbidities Before and Post-Operation

Obesity-Related Comorbidities (n, %)	Before Bariatric Surgery (n = 31)	Improved Post-Bariatric Surgery (n = 31)
Dyslipidaemia or fatty liver	26 (83.87)	19 (61.29)
Hyperuricemia	10 (32.26)	8 (25.81)
Diabetes mellitus	9 (29.03)	7 (22.58)
PCOS	4 (12.90)	4 (12.90)
Thyroid disease	4 (12.90)	2 (6.45)
Sleep apnea syndrome	3 (9.68)	3 (9.68)
Hypertension	3 (9.68)	3 (9.68)

Note: Data are presented as numbers (percentages).

Abbreviation: PCOS, polycystic ovary syndrome.

Table 4 Comparison of Results Based on Pregnancy Intervals in All Case

Details	Postoperative Pregnancy Interval < 2 Years (n = 10)	Postoperative Pregnancy Interval ≥ 2 Years (n = 20)	P
Mean age at the time of surgery (years)	30.50 (28.50, 32.00)	29.50 (26.00, 31.00)	0.310^b
Type of surgery, n (%)			1.000^c
LSG	6 (60.00)	11 (55.00)
LRYGB	4 (40.00)	9 (45.00)
Abortion, n (%)	7 (70.00)	5 (25.00)	0.045^c,*

Notes: Data are presented as median (P25, P75) or numbers (percentages). ^bNonparametric test; ^cFisher’s exact test. *P < 0.05.

Abbreviations: LRYGB, laparoscopic Roux-en-Y gastric bypass; LSG, laparoscopic sleeve gastrectomy.

Table 5 Pregnancy Characteristics of Pregnant Women Who Delivered Successfully After Bariatric Surgery

Pregnancy Characteristics	All (n = 18)
Average interval from operation to pregnancy (weeks)	29.00 (24.00, 60.00) (24.00, 60.00)
Average gestational weeks of delivery (weeks)	38.99 ± 1.64
Mode of delivery, n (%)
Vaginal	10 (55.56)
Cesarean section	8 (44.44)
Maternal complications, n (%)
GDM or diabetes complicated with pregnancy	5 (27.78)
Hypertensive disorders of pregnancy	2 (11.11)
Pregnancy complicated with thyroid disease	2 (11.11)
Pregnancy complicated with anemia	6 (33.33)
Neonatal characteristics
Average birth weight (kg)	3.17 ± 0.49
Premature delivery, n (%)	1 (5.56)
Neonatal intensive care, n (%)	2 (11.11)

Note: Data are presented as mean ± S.D. or median (P25, P75) or numbers (percentages).

Abbreviation: GDM, gestational diabetes mellitus.

Table 6 Comparison of Results Based on Pregnancy Intervals in Those with Successful Postoperative Delivery

Details	A1 (n = 9)	A2 (n = 9)	P
Type of surgery, n (%)			0.640^c
LSG	3 (33.33)	5 (55.56)
LRYGB	6 (66.67)	4 (44.44)
Weight at conception (kg)	68.00 (63.50, 80.50)	64.00 (56.50, 97.50)	0.670^b
Weight gain during pregnancy (kg)	13.44 ± 3.57	12.72 ± 7.93	0.810^a
Weight in the third trimester (kg)	78.00 (76.00, 92.50)	75.00 (67.50, 106.50)	0.670^b
Weight post delivery (kg)	72.00 (63.50, 89.50)	70.00 (61.00, 91.50)	0.670^b
Weight 1 year post delivery (kg)	73.50 (60.50, 87.00)	68.00 (60.00, 88.50)	0.610^b
Gestation week of delivery (week)	39.67 ± 1.73	38.32 ± 1.30	0.080^a
With pregnancy complications, n (%)	6 (66.67)	6 (66.67)	1.000^c
Type of delivery			0.640^c
LSCS	5 (55.56)	3 (33.33)
Normal	4 (44.44)	6 (66.67)
Mean weight of babies (kg)	3.28 ± 0.60	3.07 ± 0.36	0.360^a

Notes: A1 patients with postoperative pregnancy interval of less than or equal to 2 years and A2 patients with postoperative pregnancy intervals of more than 2 years. Data are presented as mean ± SD or median (P25, P75) or percentages (numbers). ^aStudent’s t-test; ^bNonparametric test; ^cFisher’s exact test.

Abbreviations: LRYGB, laparoscopic Roux-en-Y gastric bypass; LSG, laparoscopic sleeve gastrectomy; LSCS, lower segment cesarean section.

Table 7 Comparison of Results Based on BMI at Conception

Details	B1 (n = 13)	B2 (n = 5)	P
Type of surgery, n (%)			0.310^c
LSG	7 (53.85)	1 (20.00)
LRYGB	6 (46.15)	4 (80.00)
Weight at conception (kg)	62.77 ± 7.94	102.20 ± 28.23	0.030^a,*
Weight gain during pregnancy (kg)	12.42 ± 4.17	14.80 ± 9.73	0.470^a
Weight in the third trimester (kg)	75.00 (69.50, 78.50)	105.00 (96.00, 144.00)	0.000^b,***
Weight post delivery (kg)	65.00 (61.00, 72.00)	94.00 (84.50, 136.50)	0.000^b,***
Weight 1 year post delivery (kg)	68.00 (56.50, 73.75)	87.00 (78.50, 146.50)	0.010^b,*
Gestation week of delivery (weeks)	38.58 ± 1.63	40.06 ± 1.23	0.090^a
With pregnancy complications, n (%)	8 (61.54)	4 (80.00)	0.620^c
Type of delivery, n (%)			1.000^c
LSCS	6 (46.15)	2 (40.00)
Normal	7 (53.85)	3 (60.00)
Mean weight of babies (kg)	3.17 ± 0.56	3.19 ± 0.32	0.940^a

Notes: B1 included patients with BMI < 30 kg/m² and B2 included patients with BMI ≥ 30 kg/m² at conception. Data are presented as mean ±SD or median (P25, P75) or percentages (numbers). ^aStudent’s t-test; ^bNonparametric test; ^cFisher’s exact test. *P < 0.05. ***P < 0.001.

Abbreviations: LRYGB, laparoscopic Roux-en-Y gastric bypass; LSCS, lower segment cesarean section; LSG, laparoscopic sleeve gastrectomy.