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Longer time interval between bariatric surgery and childbirth may decrease perinatal risks

Waiting longer than two years after bariatric surgery to give birth may decrease the risk of having a premature or small baby, or a baby requiring admission to a neonatal intensive care unit (NICU).

Results of a new study show that babies born within two years of their mothers’ bariatric surgery may have increased risks for these perinatal complications. These risks may decrease with a longer time interval between surgery and childbirth.

Bariatric surgery, such as gastric bypass and gastric banding, can result in dramatic weight loss over the 12 to 16 months following the operation, according to background information provided in the study. It may also reduce the risk of pregnancy complications related to obesity, such as maternal diabetes, high blood pressure and macrosomic infants (very large babies).

However, bariatric surgery can also result in nutritional deficiencies following the procedure. It’s possible that these deficiencies may affect fetal development in women who become pregnant after bariatric surgery.

The study, led by Dr. Brodie Parent of the University of Washington Medical Centre, looked at the health of newborns of women who had undergone bariatric surgery. The researchers compared these infants to those born to women who had not had the surgery, and also looked at different time intervals between the women’s bariatric surgery and childbirth.

The results showed that infants of women who had bariatric surgery had increased risks for certain perinatal complications. Some of these complications were more common in the infants of mothers who gave birth within two years of bariatric surgery, compared to those whose surgery was less recent.

The retrospective cohort study included 10,296 women from the state of Washington, and their infants: 1,859 women who had undergone bariatric surgery between 1980 and 2013, and a control group of 8,437 women who had not had the surgery. Compared to the women who had not had the surgery, the women who had bariatric surgery were significantly more likely to have infants who were:

  • born prematurely (14 per cent compared to 8.6 per cent in the control group)
  • admitted to a NICU (15.2 per cent compared to 11.3 per cent in the control group)
  • small for gestational age (13 per cent compared to 1.9 per cent in the control group)
  • given a low Apgar score (17.5 per cent compared to 14.8 per cent in the control group)

Among women who had had bariatric surgery, some perinatal risks were significantly higher in those who gave birth within two years of giving birth, compared to those who gave birth four years or more after bariatric surgery. Those giving birth more recently had higher rates of:

  • prematurity (17.2 per cent compared to 11.8 per cent in those with less recent surgery)
  • NICU admission (17.7 per cent compared to 12.1 per cent in those with less recent surgery)
  • small for gestational age infant (12.7 per cent compared to 9.2 per cent in those with less recent surgery)

The researchers concluded that some of the increased risks linked to giving birth after bariatric surgery may decrease after two years. These results may help women and healthcare providers make decisions about pregnancy planning after bariatric surgery.

The study was published online in JAMA Surgery on Oct. 19, 2016.

 

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  • A publication of:
  • Women's College Hospital