Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May;214(5):655.e1-7.
doi: 10.1016/j.ajog.2015.11.017. Epub 2015 Nov 25.

Impact of bariatric surgery on fetal growth restriction: experience of a perinatal and bariatric surgery center

Audrey Chevrot  1 , Gilles Kayem  1 , Muriel Coupaye  2 , Ninon Lesage  1 , Simon Msika  3 , Laurent Mandelbrot  4
Affiliations

Impact of bariatric surgery on fetal growth restriction: experience of a perinatal and bariatric surgery center

Audrey Chevrot et al. Am J Obstet Gynecol. 2016 May.

Abstract

Background: Bariatric surgery is known to improve some pregnancy outcomes, but there is concern that it may increase the risk of small for gestational age.

Objective: To assess the impact of bariatric surgery on pregnancy outcomes and specifically of the type of bariatric surgery on the risk of fetal growth restriction.

Study design: A single-center retrospective case-control study. The study group comprised all deliveries in women who had undergone bariatric surgery. To investigate the effects of weight loss on pregnancy outcomes, we compared the study group with a control group matched for presurgery body mass index. Secondly, to assess the specific impact of the type of surgery on the incidence of fetal growth restriction in utero, we distinguished subgroups with restrictive and malabsorptive bariatric surgery, and compared outcomes for each of these subgroups with a second control group, matched for prepregnancy body mass index.

Results: Among 139 patients operated, 58 had a malabsorptive procedure (gastric bypass) and 81 a purely restrictive procedure (72 a gastric banding and 9 a sleeve gastrectomy). Compared with controls matched for presurgery body mass index, the study group had a decreased rate of gestational diabetes (12% vs 23%, P = .02) and large for gestational age >90th percentile (11% vs 22%, P = .01) but an increased rate of small for gestational age <10th percentile. The incidence of small for gestational age was higher after gastric bypass (29%) than it was after restrictive surgery (9%) or in controls matched for prepregnancy body mass index (6%) (P < .01 between bypass and controls). In multivariable analysis, after adjustment for other risk factors, gastric bypass remained strongly associated with small for gestational age (adjusted odds ratio, 7.16; 95% confidence interval, 2.74-18.72).

Conclusion: Malabsorptive bariatric surgery was associated with an increased risk of fetal growth restriction.

Keywords: bariatric surgery; body mass index; fetal growth restriction; gastric banding; gastric bypass; obesity; pregnancy.

PubMed Disclaimer

Comment in