Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass

Abstract

Objective: To compare perinatal and pregnancy outcomes including adherence to the Institute of Medicine’s (IOM) recommendations for gestational weight gain (GWG) in pregnant women with conception <18 months (early group) compared to ≥18 months following gastric bypass (late group).

Methods: Retrospective cohort study comprising 71 women with gastric bypass and a singleton pregnancy presenting at Odense University Hospital, November 2007–October 2013. Data were extracted from medical records and laboratory systems. The primary outcomes were timing of pregnancy and adherence to the IOM’s recommendations for GWG. Secondary outcomes were birthweight, preterm delivery, cesarean section (CS), iron deficiency and post partum hemorrhage (PPH).

Results: Forty-three (61%) women conceived less than 18 months after gastric bypass surgery. Women in the late group had a significantly higher risk of requiring CS or receiving intravenous iron supplementation compared to the early group (57% versus 30%, p = 0.03 and 29% versus 7%, p = 0.02, respectively). Early conception was not significantly associated with insufficient GWG, preterm delivery or birthweight. Among 54 women with information on GWG, only 13 (24%) had an appropriate GWG.

Conclusion: The majority of pregnant women with gastric bypass did not fulfill guidelines for GWG; however, this study could not support the recommendation to postpone pregnancy.

• Bariatric surgery
• gestational weight gain
• maternal outcome
• neonatal outcome
• pregnancy

Acknowledgments

Data retrieval was approved by the Danish Data Protection Agency (J.no. 2013–41-2217).

Declaration of interest

RKS has received consultant and lecture fees from Novo Nordisk. The authors report no conflicts of interest.