Prior weight-loss surgery improves pregnancy outcomes

Chicago, November 19: Obese women who get under the knife for a weight reduction before conceiving may experience positive maternal and neonatal outcomes as compared to pregnant women who are obese, results of a new study suggest.

75 articles assessing associations of bariatric surgery with pregnancy outcomes were reviewed for the study. Data analysis clearly marked an 800 percent increase in the bariatric surgery rates between 1998 and 2005, indicating 83 percent female patients.

Besides improving the chances of getting pregnant (obese women have difficulty getting pregnant), bariatric surgery, popularly known as weight loss surgery, cuts down maternal complications like gestational diabetes and preeclampsia (pregnancy-induced hypertension). It also reduces the amount of maternal weight gain during pregnancy.

Similarly, incidences of premature delivery and lower birth weight were found slashed indicating better newborn outcomes.

Undergoing bariatric surgery before getting pregnant clearly negated the incidence of gestational diabetes (0 percent vs. 22.1 percent) and preeclampsia (0 percent vs. 3.1 percent) in the bariatric surgery group than in the obese women group. Quantum of weight gain also dipped in the surgical group.

Newborn outcomes also improved significantly in the bariatric surgery group as compared to non-surgical obese group: premature delivery (7.7 percent vs. 7.1 percent); low birth weight (7.7 percent vs. 10.6 percent); and macrosomia (overly large body) (7.7 percent vs. 14.6 percent).

"Research is needed to better delineate the extent to which surgery and subsequent weight loss improve fertility and pregnancy outcomes. Optimizing success for contraception and producing healthy neonates following surgery will require a multidisciplinary effort by surgeons, primary care physicians, reproductive fertility specialists, obstetricians, and patients,” the authors write in the Journal of the American Medical Association’s issue published on Nov. 19.

Bariatric surgery, the surgical procedure performed to treat obesity, typically modifies the gastrointestinal tract by making the stomach smaller. The modifications help reduce nutrient intake and absorption, thus keeping a check on future weight gain.

Despite the positives, the surgical procedure proved problematic for some. Women whose stomach size was reduced using devices like bands or staples experienced discomfort and had to opt for removal after they became pregnant. Likewise, few other experienced pregnancy complications most likely related to the surgery.

“Ideally, women should wait a year after the surgery to get pregnant to let their bodies adjust” Dr. Melinda Maggard, a surgeon and researcher at the RAND Corp. in Santa Monica, California recommended.