Document Detail


Reproductive outcome after bariatric surgery: a critical review.
MedLine Citation:
PMID:  19136457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: After many cycles of weight loss and weight gain, more and more morbidly obese patients undergo bariatric surgery, like gastric banding or gastric bypass, as the ultimate treatment for their obesity-problem. Since women of reproductive age are candidates for bariatric surgery, concerns arise regarding the potential impact on future pregnancy. METHODS: English-language articles were identified in a PUBMED search from 1982 to January 2008 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding. RESULTS: The few reported case-control and cohort studies clearly show improved fertility and a reduced risk in obstetrical complications, including gestational diabetes, macrosomia and hypertensive disorders of pregnancy, in women after operatively induced weight loss when compared with morbidly obesity women. The incidence of intrauterine growth restriction (IUGR) appears to be increased, however. No conclusions can be drawn concerning the risk for preterm labour and miscarriage, although these risks are probably increased compared with controls matched for body mass index. Operative complications are not uncommon with bariatric surgery and several cases have pointed to the increased risk for intestinal hernias and nutritional deficiencies in subsequent pregnancy. Deficiencies in iron, vitamin A, vitamin B(12), vitamin K, folate and calcium can result in both maternal complications, such as severe anaemia, and fetal complications, such as congenital abnormalities, IUGR and failure to thrive. CONCLUSIONS: Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can help to prevent nutrition-related complications and improve maternal and fetal health, in this high-risk obstetric population.
Authors:
Isabelle Guelinckx; Roland Devlieger; Greet Vansant
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-01-08
Journal Detail:
Title:  Human reproduction update     Volume:  15     ISSN:  1460-2369     ISO Abbreviation:  Hum. Reprod. Update     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-02-05     Completed Date:  2009-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9507614     Medline TA:  Hum Reprod Update     Country:  England    
Other Details:
Languages:  eng     Pagination:  189-201     Citation Subset:  IM    
Affiliation:
Department of Nutrition-Preventive Medicine, Leuven Food Science and Nutrition Research Centre, University Hospital Gasthuisberg, Catholic University Leuven, Belgium. isabelle.guelinckx@med.kuleuven.be
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MeSH Terms
Descriptor/Qualifier:
Bariatric Surgery*
Case-Control Studies
Cohort Studies
Female
Fertility
Fetal Growth Retardation / epidemiology
Humans
Incidence
Postoperative Complications*
Pregnancy
Pregnancy Complications / epidemiology*
Pregnancy Outcome
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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