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Leite S, O'Kane M. Paired Editorial: Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery-A Multicenter Observational Cohort Study. Obes Surg 2024:10.1007/s11695-024-07447-3. [PMID: 39182001 DOI: 10.1007/s11695-024-07447-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Silvia Leite
- Department of Nutrition, Post-Graduate Program in Human Nutrition, University of Brasilia, Brasilia, DF, 70910-900, Brazil.
| | - Mary O'Kane
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Heusschen L, Berendsen AAM, van Bon AC, van Laar JOEH, Krabbendam I, Hazebroek EJ. Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study. Obes Surg 2024:10.1007/s11695-024-07446-4. [PMID: 39141187 DOI: 10.1007/s11695-024-07446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 07/04/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION Pregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized "weight loss surgery" multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS. METHODS Multicenter observational cohort study including 119 pregnant women at 41.0 (18.5-70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users. RESULTS During pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users. CONCLUSION Low maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population.
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Affiliation(s)
- Laura Heusschen
- Division of Human Nutrition and Health, Wageningen University, PO Box 17 6700 AA, Wageningen, The Netherlands.
- Department of Bariatric Surgery, Vitalys, Part of Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands.
| | - Agnes A M Berendsen
- Division of Human Nutrition and Health, Wageningen University, PO Box 17 6700 AA, Wageningen, The Netherlands
| | - Arianne C van Bon
- Department of Internal Medicine, Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands
| | - Judith O E H van Laar
- Department of Obstetrics and Gynecology, Máxima Medical Center, PO Box 7777, 5500 MB, Veldhoven, The Netherlands
| | - Ineke Krabbendam
- Department of Obstetrics and Gynecology, Hospital Gelderse Vallei, PO Box 9025, 6710 HN, Ede, The Netherlands
| | - Eric J Hazebroek
- Division of Human Nutrition and Health, Wageningen University, PO Box 17 6700 AA, Wageningen, The Netherlands
- Department of Bariatric Surgery, Vitalys, Part of Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, The Netherlands
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Deleus E, Lannoo M, Ceulemans D, Devlieger R, Van der Schueren B, Benhalima K. Gestational Weight Gain Following Metabolic Bariatric Surgery: A Scoping Review. Nutrients 2024; 16:2516. [PMID: 39125396 PMCID: PMC11313895 DOI: 10.3390/nu16152516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Metabolic bariatric surgery remains the most effective and durable treatment for severe obesity. Women of reproductive age represent the largest demographic group undergoing these procedures. Metabolic bariatric surgery can have both beneficial and adverse effects on pregnancy outcomes. One of the most common adverse effects is fetal growth restriction. To mitigate these adverse effects, it is crucial to explore lifestyle modifications aimed at promoting a healthy pregnancy. Modifiable factors during pregnancy after metabolic bariatric surgery include the amount of gestational weight gain. The aim of this comprehensive review is to provide an overview of what is known about gestational weight gain in pregnancy after bariatric metabolic surgery. This review is focused on the two most performed procedures: sleeve gastrectomy and Roux-en-Y gastric bypass.
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Affiliation(s)
- Ellen Deleus
- Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium; (M.L.); (B.V.d.S.); (K.B.)
- Department of Abdominal Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Matthias Lannoo
- Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium; (M.L.); (B.V.d.S.); (K.B.)
- Department of Abdominal Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Dries Ceulemans
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (D.C.); (R.D.)
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (D.C.); (R.D.)
- Department of Obstetrics and Gynecology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Bart Van der Schueren
- Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium; (M.L.); (B.V.d.S.); (K.B.)
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Katrien Benhalima
- Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium; (M.L.); (B.V.d.S.); (K.B.)
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
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4
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Davis MG, Sanders BD. Updates in Medical and Surgical Weight Loss. J Midwifery Womens Health 2024; 69:414-421. [PMID: 38831484 DOI: 10.1111/jmwh.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/24/2024] [Indexed: 06/05/2024]
Abstract
The number of individuals with obesity is at an all-time high, and the rate of obesity continues to climb each year. Obesity is a chronic disease with widespread effects throughout the body. Midwives and perinatal care providers need an understanding of the etiology, pathophysiology, and interventions for obesity. A review of evidence-based diet and lifestyle modifications, medications, and surgical procedures is presented.
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Affiliation(s)
- Melissa G Davis
- Vanderbilt University School of Nursing and Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bethany D Sanders
- Vanderbilt University School of Nursing and Vanderbilt University Medical Center, Nashville, Tennessee
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Huluță I, Apostol LM, Botezatu R, Panaitescu AM, Gică C, Sima RM, Gică N, Nedelea FM. Beyond Weight Loss: A Comprehensive Review of Pregnancy Management following Bariatric Procedures. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:635. [PMID: 38674281 PMCID: PMC11052297 DOI: 10.3390/medicina60040635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
The increasing prevalence of bariatric surgery among women of childbearing age raises critical questions about the correct management of pregnancy following these procedures. This literature review delves into the multifaceted considerations surrounding pregnancy after bariatric surgery, with a particular focus on the importance of preconception counselling, appropriate nutrition assessment, and the necessity of correct folic acid supplementation. Key areas of investigation include nutrient absorption challenges, weight gain during pregnancy, and potential micronutrient deficiencies. Examining the relationship between bariatric surgery and birth defects, particularly heart and musculoskeletal issues, uncovers a twofold increase in risk for women who underwent surgery before pregnancy, with the risk emphasized before folic acid fortification. In contrast, a nationwide study suggests that infants born to mothers with bariatric surgery exhibit a reduced risk of major birth defects, potentially associated with improved glucose metabolism. In addition, this review outlines strategies for managing gestational diabetes and other pregnancy-related complications in individuals with a history of bariatric surgery. By synthesizing existing literature, this paper aims to provide healthcare providers with a comprehensive framework for the correct management of pregnancy in this unique patient population, promoting the health and well-being of both mother and child.
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Affiliation(s)
- Iulia Huluță
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
- Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Livia-Mihaela Apostol
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
| | - Radu Botezatu
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
- Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Maria Panaitescu
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
- Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Corina Gică
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
- Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Romina-Marina Sima
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
| | - Nicolae Gică
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
- Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Florina Mihaela Nedelea
- Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania; (I.H.); (L.-M.A.); (R.B.); (A.M.P.); (C.G.); (R.-M.S.)
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Breslin TB, Dindinger RA, Andromalos L, Agunsday J. Perinatal Care for People With a History of Metabolic and Bariatric Surgery: AWHONN Practice Brief #19. Nurs Womens Health 2023; 27:e6-e8. [PMID: 37791944 DOI: 10.1016/j.nwh.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
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7
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Perinatal Care for People With a History of Metabolic and Bariatric Surgery: AWHONN Practice Brief #19. J Obstet Gynecol Neonatal Nurs 2023; 52:e8-e10. [PMID: 37791934 DOI: 10.1016/j.jogn.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
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Felsenreich DM, Malzner A, Eichner M, Hoelbing E, Moosbrugger A, Beckerhinn P, Prager G, Brix JM, Itariu BK. [Indications and preoperative planning for bariatric surgery]. Wien Klin Wochenschr 2023; 135:721-728. [PMID: 37821695 PMCID: PMC10567874 DOI: 10.1007/s00508-023-02271-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 10/13/2023]
Abstract
These clinical practice guidelines represent the consensus opinion of a group of Austrian specialist physicians associated with the treatment of obesity. The recommendations incorporate the current literature and guidelines and aim to balance both procedural feasibility and patient acceptance and adherence. Special emphasis was placed on simplification of the preoperative clarification and maximum patient safety. Therefore, this article makes no claim to be complete in all fields.
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Affiliation(s)
- Daniel Moritz Felsenreich
- Klinische Abteilung für Viszeralchirurgie, Universitätsklinik für Allgemeinchirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Andrea Malzner
- Abteilung für Innere Medizin I, Gastroenterologie und Hepatologie, Rheumatologie, Endokrinologie und Diabetologie, Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Marlies Eichner
- 3. Medizinische Abteilung mit Stoffwechselerkrankungen und Nephrologie, Klinik Hietzing, Wien, Österreich
| | | | - Alexander Moosbrugger
- Abteilung für Innere Medizin II, Krankenhaus der Barmherzigen Brüder, Graz, Österreich
| | - Philipp Beckerhinn
- Abteilung für Chirurgie, Landesklinikum Hollabrunn, Hollabrunn, Österreich
| | - Gerhard Prager
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Johanna Maria Brix
- 1. Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Klinik Landstraße, Wien, Österreich
- Karl Landsteiner Institut für Adipositas und Stoffwechselerkrankungen, Klinik Landstraße, Wien, Österreich
| | - Bianca-Karla Itariu
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
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9
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Różańska-Walędziak A, Walędziak M, Mierzejewska A, Skopińska E, Jędrysik M, Chełstowska B. Nutritional Implications of Bariatric Surgery on Pregnancy Management-A Narrative Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1864. [PMID: 37893582 PMCID: PMC10608240 DOI: 10.3390/medicina59101864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/01/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
One in three women of reproductive age is obese. The mainstay treatment for obesity is bariatric surgery, and the following weight reduction results in a decrease in pregnancy adverse effects, including gestational diabetes mellitus, pregnancy-induced hypertension, and macrosomia. However, nutritional and vitamin deficiencies due to changes in the gastrointestinal tract after bariatric surgery are associated with an increase in the risk of fetal growth retardation and small for gestational-age neonates. The purpose of this review was to analyze the available recent literature on the subject of the management of pregnancy after bariatric surgery. We searched for available articles from 2007 to 2023 and chose articles of the greatest scientific and clinical value. Micronutrient, vitamin, and protein supplementation is recommended in the prenatal period and throughout the pregnancy. It is advised that pregnant women with a history of bariatric surgery should be provided with regular specialist dietary care. There is still a lack of recommendations about the optimum gestational weight gain after different types of bariatric surgery and for patients of different metabolic statuses. Women of reproductive age undergoing bariatric procedures should be provided with appropriate counseling about adequate contraception, the recommended time-to-conception interval, and the positive and negative influence of bariatric surgery on perinatal outcomes.
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Affiliation(s)
- Anna Różańska-Walędziak
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (A.R.-W.); (A.M.); (E.S.)
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine—National Research Institute, Szaserów 128 St., 04-141 Warsaw, Poland
| | - Anna Mierzejewska
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (A.R.-W.); (A.M.); (E.S.)
| | - Ewa Skopińska
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (A.R.-W.); (A.M.); (E.S.)
| | - Malwina Jędrysik
- Department of Biochemistry and Laboratory Diagnostics, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.J.); (B.C.)
| | - Beata Chełstowska
- Department of Biochemistry and Laboratory Diagnostics, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.J.); (B.C.)
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10
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Tabesh MR, Eghtesadi M, Abolhasani M, Maleklou F, Ejtehadi F, Alizadeh Z. Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: An Updated Comprehensive Practical Guideline. Obes Surg 2023; 33:2557-2572. [PMID: 37389806 DOI: 10.1007/s11695-023-06703-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/18/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
Only in the USA, 315 billion dollars are spent annually on the medical cost of obesity in adult patients. Till now, bariatric surgery is the most effective method for treating obesity and can play an essential role in reducing the direct and indirect costs of obesity treatment. Nonetheless, there are few comprehensive guidelines which include nutrition, physical activity, and supplements, before and after surgery. The purpose of the present narrative review is to provide an updated and comprehensive practical guideline to help multidisciplinary teams. The core keywords include nutrition, diet, physical activity, exercise, supplements, macronutrients, micronutrients, weight reduction, bariatric surgery, Roux-en-Y Gastric Bypass, Sleeve Gastrostomy, Laparoscopic Adjustable Gastric Banding, and Biliopancreatic diversion with duodenal switch which were searched in databases including PubMed/Medline, Cochrane, and some other sources such as Google Scholar. We answered questions in five important areas: (a) nutritional strategies before bariatric surgery, (b) nutrition after bariatric surgery, (c) physical activity before and after bariatric surgery, (d) weight regain after bariatric surgery, and (e) micronutrient assessments and recommendations before and after bariatric surgery. Some new items were added in this updated guideline including "weight regain" and "pregnancy after bariatric surgery." Other fields were updated based on new evidence and guidelines.
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Affiliation(s)
| | - Maryam Eghtesadi
- Sports and Exercise Medicine Department, Tehran University of Medical Sciences, No. 7, Ale-ahmad Highway, Tehran, 14395-578, Iran
| | - Maryam Abolhasani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Maleklou
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ejtehadi
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Alizadeh
- Sports and Exercise Medicine Department, Tehran University of Medical Sciences, No. 7, Ale-ahmad Highway, Tehran, 14395-578, Iran.
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Burlina S, Dalfrà MG, Lapolla A. Pregnancy after Bariatric Surgery: Nutrition Recommendations and Glucose Homeostasis: A Point of View on Unresolved Questions. Nutrients 2023; 15:nu15051244. [PMID: 36904243 PMCID: PMC10005384 DOI: 10.3390/nu15051244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Obesity is increasing in all age groups and, consequently, its incidence has also risen in women of childbearing age. In Europe, the prevalence of maternal obesity varies from 7 to 25%. Maternal obesity is associated with short- and long-term adverse outcomes for both mother and child, and it is necessary to reduce weight before gestation to improve maternal and fetal outcomes. Bariatric surgery is an important treatment option for people with severe obesity. The number of surgeries performed is increasing worldwide, even in women of reproductive age, because improving fertility is a motivating factor. Nutritional intake after bariatric surgery is dependent on type of surgery, presence of symptoms, such as pain and nausea, and complications. There is also a risk of malnutrition after bariatric surgery. In particular, during pregnancy following bariatric surgery, there is a risk of protein and calorie malnutrition and micronutrient deficiencies due to increased maternal and fetal demand and possibly due to reduction of food intake (nausea, vomiting). As such, it is necessary to monitor and manage nutrition in pregnancy following bariatric surgery with a multidisciplinary team to avoid any deficiencies in each trimester and to ensure the well-being of the mother and fetus.
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Wiggins T, Baker J, Beasley S, Fry H, Sarfraz Y, Singhal R. Clinical Dilemma of Pregnancy with Intra-gastric Balloon In Situ: Time for Formalised Guidelines? Obes Surg 2023; 33:377-378. [PMID: 36449174 DOI: 10.1007/s11695-022-06392-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Tom Wiggins
- University Hospitals Birmingham, Birmingham, UK
| | - Julia Baker
- Gastric Balloon Group, Healthier Weight, Birmingham, UK
| | | | - Heather Fry
- Gastric Balloon Group, Healthier Weight, Birmingham, UK
| | | | - Rishi Singhal
- University Hospitals Birmingham, Birmingham, UK. .,Gastric Balloon Group, Healthier Weight, Birmingham, UK. .,Birmingham City University, Birmingham, UK.
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Beiglböck H, Mörth E, Reichardt B, Stamm T, Itariu B, Harreiter J, Eichelter J, Prager G, Kautzky-Willer A, Wolf P, Krebs M. The Timing of Pregnancies After Bariatric Surgery has No Impact on Children's Health-a Nationwide Population-based Registry Analysis. Obes Surg 2023; 33:149-155. [PMID: 36344726 PMCID: PMC9834372 DOI: 10.1007/s11695-022-06346-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Bariatric surgery has a favorable effect on fertility in women. However, due to a lack of data regarding children's outcomes, the ideal time for conception following bariatric surgery is unknown. Current guidelines advise avoiding pregnancy during the initial weight loss phase (12-24 months after surgery) as there may be potential risks to offspring. Thus, we aimed to analyze health outcomes in children born to mothers who had undergone bariatric surgery. The surgery-to-delivery interval was studied. MATERIALS AND METHODS A nationwide registry belonging to the Austrian health insurance funds and containing health-related data claims was searched. Data for all women who had bariatric surgery in Austria between 01/2010 and 12/2018 were analyzed. A total of 1057 women gave birth to 1369 children. The offspring's data were analyzed for medical health claims based on International Classification of Diseases (ICD) codes and number of days hospitalized. Three different surgery-to-delivery intervals were assessed: 12, 18, and 24 months. RESULTS Overall, 421 deliveries (31%) were observed in the first 2 years after surgery. Of these, 70 births (5%) occurred within 12 months after surgery. The median time from surgery to delivery was 34 months. Overall, there were no differences noted in frequency of hospitalization and diagnoses leading to hospitalization in the first year of life, regardless of the surgery-to-delivery interval. CONCLUSION Pregnancies in the first 24 months after bariatric surgery were common. Importantly, the surgery-to-delivery interval had no significant impact on the health outcome of the children.
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Affiliation(s)
- Hannes Beiglböck
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Eric Mörth
- grid.7914.b0000 0004 1936 7443Department of Informatics, University of Bergen, 5008 Bergen, Norway ,grid.412008.f0000 0000 9753 1393Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, 5021 Bergen, Norway
| | | | - Tanja Stamm
- grid.22937.3d0000 0000 9259 8492Center for Medical Statistics, Informatics and Intelligent Systems, Institute for Outcomes Research, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria ,grid.491977.5Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Bianca Itariu
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Jürgen Harreiter
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Jakob Eichelter
- grid.22937.3d0000 0000 9259 8492Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gerhard Prager
- grid.22937.3d0000 0000 9259 8492Department of General Surgery, Division of Visceral Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Alexandra Kautzky-Willer
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Peter Wolf
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Michael Krebs
- grid.22937.3d0000 0000 9259 8492Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Reply to: Jean Tiffany Cox. Surg Obes Relat Dis 2022; 18:1254. [PMID: 36055923 DOI: 10.1016/j.soard.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/03/2022] [Indexed: 01/12/2023]
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Nutrition for pregnancy after metabolic and bariatric surgery: literature review and practical guide. Surg Obes Relat Dis 2022; 18:1253. [PMID: 35803848 DOI: 10.1016/j.soard.2022.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/12/2022] [Indexed: 01/12/2023]
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Ben-Porat T, Bacon SL. Comment on: Nutrition for Pregnancy after Metabolic and Bariatric Surgery. Surg Obes Relat Dis 2022; 18:830-831. [DOI: 10.1016/j.soard.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
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