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
. 2022 Jun 1;17(2):103-110.
doi: 10.1089/bari.2021.0045. Epub 2022 Jun 8.

Pregnancy and Bariatric Surgery: Significant Variation in Bariatric Surgeons' Practices and Preferences: A National Survey

Daniëlle S Bonouvrie  1   2 , Sophie B M Taverne  1   3 , Loes Janssen  4 , Arijan A P M Luijten  1 , François M H van Dielen  1 , Wouter K G Leclercq  1
Affiliations

Pregnancy and Bariatric Surgery: Significant Variation in Bariatric Surgeons' Practices and Preferences: A National Survey

Daniëlle S Bonouvrie et al. Bariatr Surg Pract Patient Care. .

Abstract

Background: Bariatric complications may occur during pregnancy, potentially causing serious maternal and fetal problems. The aim of this study was to determine the current practice and preferences of bariatric surgeons regarding the pregnancy care of fertile women before and after bariatric surgery.

Methods: A 26-question anonymous online survey was designed and sent to all bariatric surgeons of the Dutch Society of Metabolic and Bariatric Surgery.

Results: At least one bariatric surgeon from each bariatric center (n = 18) completed the survey. In case of a future child, wish sleeve gastrectomy became more popular than Roux-en-Y gastric bypass. All surgeons provided preoperative education regarding bariatric complications during pregnancy. Nine centers without neonatal intensive care would not refer pregnant women with acute complications. Half of the centers had a standard operating procedure. Seven per 18 bariatric centers had seen at least one postbariatric pregnant patient with severe maternal morbidity. One case of perinatal mortality was reported.

Conclusion: There is an inconsistent and often below guideline standard daily practice regarding pregnancy before and after bariatric surgery. There is limited experience with pregnant women with acute bariatric complications. Referral to tertiary centers is inadequate. Better information provision for both professionals and patients regarding possible complications is needed.

Keywords: bariatric surgery; counseling; education; fertile women; preferences; pregnancy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

FIG. 1.
FIG. 1.
Flowchart of study population selection.
FIG. 2.
FIG. 2.
Advised bariatric procedure for fertile women. RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy.
FIG. 3.
FIG. 3.
Referral of women with a future child wish and pregnant women after bariatric surgery.
FIG. 4.
FIG. 4.
Differential diagnoses in pregnant women with acute abdominal pain after bariatric surgery.
See this image and copyright information in PMC

References

    1. Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 2015;16:621–638. - PubMed
    1. Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M, et al. . Pregnancy and fertility following bariatric surgery: a systematic review. JAMA 2008;300:2286–2296. - PubMed
    1. Moran LJ, Dodd J, Nisenblat V, Norman RJ. Obesity and reproductive dysfunction in women. Endocrinol Metab Clin North Am 2011;40:895–906. - PubMed
    1. Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. . The impact of maternal BMI status on pregnancy, outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008;9:635–683. - PubMed
    1. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014;8:CD003641. - PMC - PubMed

Appendix References

    1. Heusschen L, Krabbendam I, van der Velde JM, Deden LN, Aarts EO, Merién AER, et al. . A matter of timing-pregnancy after bariatric surgery. Obes Surg 2021;31:2072–2079. - PMC - PubMed
    1. Slater C, Morris L, Ellison J, Syed AA. Nutrition in pregnancy following bariatric surgery. Nutrients 2017;9:1338. - PMC - PubMed
    1. Stopp T, Falcone V, Feichtinger M, Göbl C. Pregnancy and lactation after bariatric surgery—a consensus statement from the OEGGG. Geburtshilfe Frauenheilkd 2018;78:1207–1211. - PMC - PubMed
    1. Ouyang DW. Fertility and pregnancy after bariatric surgery. In: UpToDate. 2020. Available at https://www.uptodate.com/contents/fertility-and-pregnancy-after-bariatri.... Accessed May 19, 2020.
    1. O'Kane M, Parretti HM, Pinkney J, Welbourn R, Hughes CA, Mok J, et al. . British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update. Obes Rev 2020;21:e13087. - PMC - PubMed