Bariatric Surgery in Women of Reproductive Age-Special Concerns for Pregnancy

Over the past 10 years, procedures such bariatric surgery is increasingly being used to treat severe obesity. About 50% of the patients who undergo these treatments are women of reproductive age. The average age of women undergoing this surgery is 42. As nutrition is a vital factor of pregnancy and giving birth to a healthy baby, it is important to understand the effects of bariatric surgery, both on fertility and pregnancy results..

These deficiencies can be reduced by supplements from doctor for specific nutrients.There are a variety of surgical methods that are being used to induce weight loss in obese patients. There are different mechanisms or a combination of mechanisms that result in weight loss. At large, bariatric surgery uses three methods to induce weight loss:

1. Confining the size of the stomach and thus limiting the amount of food a patient can eat at a single meal,
2. Malabsorptive procedures reduces the amount of nutrients that are absorbed from a meal,
3. Combination of hormonal changes is induced by constructing a small gastric pouch along with a bypass.

Studies propose that bariatric surgery results in improved fertility; normalization of hormones and menstrual cycle has been observed in women with the polycystic ovarian syndrome. Studies also suggest that fertility improves following bariatric surgery and weight loss; similar to that seen when obese women lose weight through nonsurgical methods.

Children born to women who underwent bariatric surgery had a nutrient deficiency that was the result of malabsorption post-surgery and not taking prenatal vitamin supplements. The risk of pregnancy complications such as gestational diabetes, preeclampsia, and pregnancy induced hypertension in women who have undergone bariatric surgery are far less than obese women who did not undergo any weight loss procedures.

Data suggest that nutritional deficiencies are minimal in mother and child and maternal and neonatal results are acceptable with LAP-Band surgery and gastric bypass as long as sufficient nutrition and vitamin supplementation are maintained

A cohort study compared pregnancies of the same women before and after Biliopancreatic diversion (BPD), of 32 women who had unsuccessfully attempted conception prior to surgery, 47 percent were able to conceive following BPD. Surgeons suggest that patients should not attempt pregnancy within two years following bariatric surgery.

It is important to understand the positive and negative effects of bariatric procedures especially for women who intend to get pregnant post the surgery. It is important to consult the doctor before attempting pregnancy to understand the possible complications during pregnancy.