Pregnancy after bariatric surgery does not affect weight lossBMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6293 (Published 24 September 2012) Cite this as: BMJ 2012;345:e6293
- Aderinsola Alatishe, medical student1,
- Basil J Ammori, consultant laparoscopic bariatric surgeon and honorary professor of surgery1,
- Akheel A Syed, consultant endocrinologist and honorary senior lecturer1
Maternal obesity increases the risk of pregnancy complications,1 2 3 4 and rates of adverse maternal and neonatal outcomes are lower after bariatric surgery.4 5 Although women are advised to avoid pregnancy for 12-24 months after bariatric surgery owing to fears of fetal undernutrition and reduced weight loss benefits,3 4 little is known of the effects of a subsequent pregnancy on weight loss.
We identified 232 women of childbearing age (18-45 years) who had undergone bariatric surgery (197 gastric bypass, 19 gastric banding, eight sleeve gastrectomy, and eight other procedures). Mean age was 34.0 years, preoperative weight 137.7 kg, and body mass index (BMI) 50.6.
Twenty one women became pregnant after surgery. They were significantly younger at the time of surgery than the remaining women but were well matched for preoperative weight, BMI, and bariatric procedure. The median interval between bariatric surgery and first pregnancy was 11 months (range 1.5-36); pregnancy was planned in six women. Eighteen women completed pregnancy successfully, 12 by vaginal delivery and six by caesarean section; two undertook medical termination and one had a spontaneous miscarriage. The pregnancy group lost 70.4% of excess weight compared with 70.0% in the non-pregnancy group at a median 30 months after surgery.
We conclude that pregnancy after bariatric surgery in women of childbearing age is safe and does not adversely influence weight loss outcomes. However, close surveillance of maternal weight and nutritional status is advisable, particularly if conception occurs in the first year after surgery.
Cite this as: BMJ 2012;345:e6293
Competing interests: None declared.
Permission for the audit was obtained from the Caldicott Guardian of our institution.