Bariatric Surgery May Improve Pregnancy Outcomes

Bariatric surgery before pregnancy in obese women can reduce their risks for cesarean delivery and adverse neonatal outcomes, new research shows.

Results from a systematic review and meta-analysis involving more than 350,000 women, including nearly 11,000 who had undergone bariatric surgery, were presented here at the American College of Surgeons Clinical Congress 2016 by fourth-year medical students Brittanie Young, MS, and Samantha Drew from the Philadelphia College of Osteopathic Medicine (PCOM), Pennsylvania, and colleagues.

“Bariatric surgery should be considered as a risk-mitigating step towards a achieving a healthy pregnancy and delivery,” lead author A. Christopher Ibikunle, MD, assistant professor of surgery at PCOM and chief executive officer of Georgia SurgiCare, Loganville, told Medscape Medical News.

Bariatric surgery places the expectant mother at a lower risk for cesarean delivery as well as assisted vaginal delivery, which may be related to the increased risk for both large for gestational age and macrosomia in obese mothers, Young and Drew explain in their poster.

“This could [have] a potentially huge impact on clinical practice,” Young told Medscape Medical News.

The primary safety concern would be adequate nutritional intake during the pregnancy, but that can be managed, she added. “There is a common theme of postsurgical patients being nutrient and calorie deficient, which could have an effect on the developing fetus. Careful monitoring and nutritional consultation could help to address these concerns.”

Asked to comment on the findings, Richard D. Stahl, MD, medical director of bariatric surgery at the University of Alabama at Birmingham, told Medscape Medical News that because it’s a meta-analysis and not new data, “I wouldn’t say this is necessarily practice-changing, but I think it supports what our beliefs were and what our interpretation was of the data already.”


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