The effects of bariatric surgery on fetal development and neonatal outcomes

Abstract

BACKGROUND: Over two-thirds of the United States population is considered overweight or obese. Bariatric surgery is often used when conservative weight loss measures fail. The majority of bariatric surgeries are performed on women of childbearing age. Women who become pregnant following bariatric surgery have a decreased occurrence of gestational diabetes, hypertensive disorders and macrosomia, but they also have an increased risk of small for gestational age infants (SGA), with the greatest risk of SGA infants following malabsorptive and mixed bariatric surgery procedures. STUDY: A gap in the literature exists regarding the risks of SGA and intrauterine growth restriction (IUGR) following Roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy (SG), the two most common procedures in the United States in 2014. This study will be a multi-center retrospective cohort study that will identify the risk of IUGR following RYGB and SG. CONCLUSION: This study will improve our understanding of the effects on pregnancy following RYGB and SG. The most innovative, and hardest, part of this study will be the collection of data on as many SG women as possible. This will be the biggest hurdle because SG is a relatively new procedure, so the prevalence of pregnancy following SG is low. PUBLIC HEALTH SIGNIFICANCE: A better understanding of the effects of the most common bariatric procedural types on pregnancy is important given the prevalence of bariatric surgery among women of childbearing age. It will allow bariatric surgeons to better council their patients on a surgery type for those that may be considering pregnancy afterwards, and enable obstetricians to have a better understanding of the risks associated with their patient’s pregnancy.