The effect of surgery-to-conception interval on pregnancy outcomes after sleeve gastrectomy

Surg Obes Relat Dis. 2018 Dec;14(12):1795-1803. doi: 10.1016/j.soard.2018.09.485. Epub 2018 Sep 29.

Abstract

Background: The optimal timing of pregnancy after bariatric surgery has not been established, with data limited regarding laparoscopic sleeve gastrectomy (LSG), currently the most common bariatric operation performed.

Objectives: We explored associations of the surgery-to-conception interval with pregnancy outcomes after LSG.

Setting: A university hospital.

Methods: We assessed pregnancy outcomes in relation to the surgery-to-conception interval for all women who underwent LSG and delivered during 2006 to 2018.

Results: Of 154 patients, 67 (43.5%) conceived within the first 18 months postoperatively (early-pregnancy group), whereas 87 (56.5%) conceived later (late-pregnancy group). The median surgery-to-conception interval was 390 (interquartile range 247-459) days in the early-pregnancy group and 1104 (8527-1548) days in the late-pregnancy group. Compared with the early-pregnancy group, the late-pregnancy group had higher gestational weight gain (median 11 versus 8 kg, P < .001) and lower hemoglobin levels in early pregnancy (12.3 versus 12.6 g/dL, P = .03) and after delivery (10.0 versus 10.4 g/dL, P = .02). Other maternal and perinatal outcomes were similar between the groups, including the proportion of small-for-gestational-age infants (11.9% versus 14.9%, P = .64) for those who conceived within or later than 18 months after surgery. Similar rates of small-for-gestational-age infants were found between those who conceived within or ≥12 months after surgery (P = 1.0).

Conclusions: Timing of pregnancy after LSG was found not to be associated with pregnancy outcomes. Together with documentations of a similar safety profile of pregnancy occurring earlier or later in the postoperative course, these data should reassure women who do not wish to delay conception after surgery.

Keywords: Bariatric surgery; Outcomes; Pregnancy; Sleeve gastrectomy; Surgery-to-conception interval.

MeSH terms

  • Adult
  • Female
  • Gastrectomy / statistics & numerical data*
  • Humans
  • Obesity, Morbid / surgery
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies
  • Time Factors