Centegra Health System surgeon Amir Heydari, M.D. agrees with an article in the November 19 issue of JAMA that suggests rates of adverse outcomes for mothers or pregnant women and newborn babies, such as gestational diabetes and low birth weight, may be lower after bariatric surgery compared with pregnant women who are obese.
“Rates of surgical weight loss procedures have grown steeply and women account for many of these patients. Large numbers of women in their childbearing years may undergo bariatric surgery, which may change fertility following weight loss, alter nutritional requirements during pregnancy, or impact contraception to prevent pregnancy,” the authors write.
Melinda A. Maggard, M.D., M.S.H.S., of the Rand Corporation, Santa Monica, CA, and colleagues conducted a review of articles on bariatric surgery among women of reproductive age to estimate the incidence of bariatric surgery among these women and to assess associations of bariatric surgery with pregnancy outcomes. The researchers identified 75 articles for inclusion in the review.
An analysis of the data indicated that the incidence of bariatric surgery in the U.S. increased by 800 percent between 1998 and 2005 (from 12,480 to 113,500 cases). Women accounted for 83 percent of procedures in the 18- to 45-year age group, and between 2003 and 2005, more than 50,000 women in this age group underwent inpatient bariatric surgery procedures annually (49 percent of all bariatric surgery cases).
A review of several of the studies showed lower maternal complication rates after bariatric surgery than in obese women without bariatric surgery, or rates approaching those of non-obese controls. Gestational diabetes (0 percent vs. 22.1 percent) and preeclampsia (0 percent vs. 3.1 percent) were lower in the bariatric surgery group than in the obese comparison group. Maternal weight gain was reduced in the surgical group.
Newborn outcomes were similar or better after surgery compared with obese women without laparoscopic adjustable gastric band surgery (7.7 percent vs. 7.1 percent for premature delivery; 7.7 percent vs. 10.6 percent for low birth weight; 7.7 percent vs. 14.6 percent for macrosomia [overly large body]). No differences in these newborn outcomes were found after gastric bypass compared with non-obese controls.
“The use of bariatric surgery for treating severe obesity has increased dramatically over the past 10 years; about half of patients who undergo these procedures are women of reproductive age,” Heydari said. “This report was commissioned to measure the incidence of bariatric surgery in this population and review the evidence on the impact of bariatric surgery on fertility and subsequent pregnancy.”
Centegra conducts free monthly informational weight loss surgery sessions on select Wednesdays and Saturdays. Provided during the meetings are a wealth of information about the benefits, multi-disciplinary, surgery options and lifelong support available at Centegra. The next informational session is scheduled for 6 to 8 p.m. Wednesday, December 17 at Centegra Hospital – Woodstock, Route 14 and Doty Road, Woodstock, in conference rooms A & B. Registration for these sessions can be made by calling 877-CENTEGRA.
Centegra Health System is committed to meeting the healthcare needs of the residents of greater McHenry County and to making services available in multiple and convenient locations, including hospitals in McHenry and Woodstock, Immediate and Primary Care centers, Health Bridge Fitness Centers and more. As the region’s leading healthcare provider, Centegra Health System continues to bring the latest treatments and technology, along with the skills of nearly 4,000 medical professionals, to meet the needs of the growing McHenry County community.