PABS: Pregnancy after bariatric surgery

Aim The number of bariatric surgeries in Germany is about 15,000 per year and has increased tenfold in the last decade. 49% were performed in women of reproductive age. Maternal malabsorption with associated nutrient deficiencies during pregnancy may have adverse effects on fetal development. The aim of this study is to collect data for Germany on specific medical care of pregnant women after bariatric surgery and maternal and neonatal outcome.

Methods The study design is a multicenter case-control study with a targeted case number of 250 cases. As of May 2022, 153 cases from 12 centers have been included in the study. Controls will be 253 age- and BMI-matched women.

Preliminary results Mean age was 33.2+4.9 years, parity 2.2+1.2, and BMI at time of conception 31.9+6.2 kg/m². An oral glucose tolerance test (oGTT) was performed in 61.4% of pregnant women despite the risk of dumping syndrome and lack of validity.

There was a higher rate of SGA (small for gestational age) (16.3% vs. 5.5%), preterm birth (22.9% vs. 15.0%), and a lower rate of LGA (large for gestational age) (4.6% vs. 15.0%) compared to the controls. The mean gestational age at delivery was 38 wks, with a C-section rate of 48.4%, 68.9% were primary and 31.1% were emergency section

Summary The data suggest initial conclusions that the specific medical care needs of pregnant women after bariatric surgery are inadequately understood and implemented. Because of the high complication rate, pregnant women should be cared for in terms of high-risk pregnant women.

Publikationsverlauf

Artikel online veröffentlicht:
11. Oktober 2022