Pregnancy after Bariatric Surgery: Balancing Risks and Benefits

Can J Diabetes. 2017 Aug;41(4):432-438. doi: 10.1016/j.jcjd.2016.09.005. Epub 2017 Mar 29.

Abstract

The majority of bariatric surgeries in Canada are performed in women of reproductive age. Clinicians encounter more and more often pregnancies that occur after bariatric surgeries. The appropriate management and education of women who want to conceive after bariatric surgery is still unclear due to the lack of consistent data about maternal and neonatal outcomes following bariatric surgery. Maternal obesity during pregnancy confers a higher risk for gestational diabetes, hypertensive disorders, congenital malformations, prematurity and perinatal mortality. Generally, pregnancies in severely obese women who have undergone bariatric surgery are safe, and the women are at significantly lower risk for gestational diabetes, hypertensive disorders and large-for-gestational-age neonates, but the surgery confers a higher risk for small-for-gestational-age infants and prematurity. This review aims to provide evidence from recent publications about the risks and benefits of bariatric surgeries in the context of future pregnancies.

Keywords: bariatric surgery; chirurgie bariatrique; diabète gestationnel; gestational diabetes; grossesse; issues maternelles; issues néonatales; maternal outcomes; neonatal outcomes; pregnancy.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery / adverse effects
  • Bariatric Surgery / trends*
  • Birth Weight / physiology
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / epidemiology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age / metabolism
  • Obesity / epidemiology*
  • Obesity / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Risk Assessment / trends