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Tag: pregnancy post bariatric surgery

From a physical aspect, it is quite possible to have a healthy pregnancy after weight loss surgery. Recent studies suggests that having a baby after Bariatric surgery may actually be safer than a pregnancy complicated by issues stemming from obesity. Some of these issues include Gestational Diabetes, Preeclampsia and  Hypertension, all of which can affect both mother and baby. Bariatric surgery has also led to a reduced number of Cesarean births among expectant mothers who are obese.

pregnant bariatric surgery

Having a Baby after Weight Loss Surgery

The most important issue surrounding your choice to have a baby after weight loss surgery is the timing. You should wait until you have met your weight loss goal before deciding to have a baby. When your weight is stable, your body is ready to offer the nutrients your baby will need. becoming pregnant while still undergoing a rapid or consistent weight loss could lead to a low birth weight for your baby.

Most doctors and nutritionists agree that 18 to 24 months is an ideal length of time for Bariatric patients to conceive after any weight loss surgery. If you chose the lap band for your weight loss surgery, some doctors feel that twelve months is an appropriate length of time to wait before having a baby, but you may need to have your band readjusted in order to meet the needs of your body during pregnancy.

It is important to remember that your weight loss after Bariatric surgery will be quite significant in the first year, and gradual in the second year. By the third year, most Bariatric patients will have met their weight loss goals and have learned to maintain their ideal weight. Once the weight has become stable, a healthy pregnancy is not only possible but probable.

 

Consult Your Physician

Once you have decided to have a baby after weight loss surgery, consult your physician. You will need preconception planning and your doctor may want to consider nutritional supplements. Some of the more popular vitamin and mineral supplements for those trying to conceive after rapid weight loss include Calcium, Vitamin B12, Folic Acid, Iron and Vitamin D.

It may be a good idea to begin Prenatal Vitamins before conception as well as during the length of the pregnancy. Other professionals can be of great help for those who become pregnant after Bariatric surgery include registered dietitians and nutritionists, offering help in the areas of weight gain and nutrition.

The final decision to have a baby after weight loss surgery should be yours, under the advice of your trusted medical doctor. Because every person’s situation is different, your doctor will best advise you according to your personal health history. This will help you determine whether a healthy pregnancy is possible, and if it is the right choice for you, after any Bariatric surgery procedure.

 

A review of the literature says that there is no need to delay pregnancy past 12 months after bariatric surgery.  It says that post-surgery pregnancy is safe and that there is no significant differences found in the risk of gestational diabetes, admission to the neonatal intensive care unit or perinatal death.

Details of the First of Three Published Research Paperspregnancy post bariatric surgery

The American Journal of Obstetrics & Gynecology published research done by the Department of Obstetrics and Gynecology at Hvidovre University Hospital, Denmark.  This research concluded that the weight of newborn babies from mothers who’ve had bariatric surgery does not show any significant difference compared to newborn babies from mothers who’ve not had the surgery.  This research also showed no significant difference statistically between mothers and newborns regarding the risk of gestational diabetes mellitus, preeclampsia during pregnancy, the need to have labor induced, the need for a caesarean section, hemorrhaging post-partum, need for the newborn to be admitted to the neonatal intensive care unit or perinatal death.

Slight but No Significant Differences

Dr. Mette M Kjaer, the lead author of the study told Reuters Health that although they expected to find “a positive impact on maternal complications, especially the risk of gestational diabetes mellitus, after matching for BMI we did not find any difference between the groups.”  What they did find were very slight differences in the subjects who had bariatric surgery.  Their babies had a shorter mean gestational age, 274 vs. 278 days (p<0.001), a lower mean weight at birth, 3,312g vs. 3,585g (p<0.001) and a lower risk of being large for gestational age and a higher risk of being small for gestational age as compared to babies born to mothers in the non- surgery group.  These differences too, were not clinically significant.

The study examined 339 women who had their babies after bariatric surgery with 84.4% of these having undergone gastric bypass.  They were matched with 1,277 mothers of similar age, BMI and delivery date, who had not had bariatric surgery.  The BMI in the surgery group was slightly higher than the non-surgery group (32.4 vs. 32.2).  Even though the study found that most women and their babies do well after surgery, they should still monitor fetal growth and nutrition as there may be a need for vitamin supplementation.  Kjaer added that “Paradoxically, babies who are both small-or-large-for-gestational-age are at increased risk of later obesity and metabolic syndrome”.

A Second Research Paper Regarding Delaying Pregnancy

The same researchers published a second paper in the Obesity Surgery Journal in which they essentially agreed with a study done previously that concluded that women should delay pregnancy for at least a year after bariatric surgery.  They also concluded that there was no evidence showing that waiting any longer would make any difference.

They studied a total of 286 women who became pregnant after gastric bypass surgery.  Of these 158 conceived within the first year and 128 conceived later.  And the study showed there was no statistically significant difference between the two groups of mothers for any of the risk factors mentioned earlier in this article.  It must be noted that the best time for pregnancy after having gastric bypass surgery has not been determined yet.

A Third Paper Reviewed 17 Flawed Studies

There was a third paper, a review of 17 papers,  published in the Acta Obstetricia et Gynecologica Scandinavica journal which recommended larger studies, that matched or adjusted for BMI, be done to confirm the accuracy of the prior conclusion of pregnancy after bariatric surgery being safe.

The problem with these 17 studies was that study design was not homogeneous enough and that six of the studies had less than 50 subjects with bariatric surgery.  There were many slight differences between the groups studied, but on closer examination the differences were invalid as the study design was flawed.  They did find a single study indicating a higher risk of birth defects after surgery, but not significantly higher.