Wait at least 2 years after bariatric surgery

Obesity surgeries are becoming more and more common in France. Women of childbearing age are particularly affected. A recent study shows that it is preferable to wait at least 2 years after a bariatric surgery to embark on pregnancy. Indeed, if the delay is too short, the surgery can have serious consequences for infants. Explanations.

Bariatric surgery, becoming more common

Obesity surgeries or bariatric surgeries are used in cases of extreme obesity. They are experiencing rapid development in France with almost 450,000 operations performed between 2006 and 2017. These operations are reserved for people:

  • With a body mass index (BMI) > 40 kg/m² or > 35 kg/m² with complications such as type 2 diabetes, high blood pressure or sleep apnea syndrome;
  • age between 18 and 60;
  • Have no psychological contraindications;
  • Does not present any particular operational risk.

Bariatric surgery combines several surgical techniques. They are performed under laparoscopy. These operations are not insignificant and require good physical and psychological preparation:

  • Restrictive surgical procedures that limit the ability to eat. They aim to reduce the volume likely to receive food. This may involve placing an adjustable gastric band or partially removing the stomach (Sleeve gastrectomy);
  • Combination surgeries combine gastric narrowing with the installation of a bypass of the digestive tract (bypass).

They are increasingly occurring in women of childbearing age. In fact, they reduce the risks associated with obesity during pregnancy, such as preeclampsia or gestational diabetes.

Effects of bariatric surgery on pregnancy

Doctors from the University Hospital of Coimbra in Portugal wanted to study the effects of bariatric surgery on pregnancy. In particular, they examined the influence of the time interval between bariatric surgery and pregnancy on the health of the newborn. To do this, they conducted a retrospective study of 48 pregnancies that took place after bariatric surgery.

The women included in the study were on average 34.3 years old at the time of birth. Her average BMI was 30.9. These women underwent different types of bariatric surgeries (gastric bypass, gastrectomy, gastric banding or biliopancreatic diversion). In addition, 14.6% of the births occurred less than 12 months after the operation, 14.6% of the cases between 12 and 24 months later, and 70.8% of the births more than 2 years later.

The results of the study show that 26.3% of infants were born small for their gestational age (PGA). In particular, the time between surgery and conception was significantly shorter in PGA newborns. In addition, analyzes show that the longer the woman waits to conceive, the lower the risk of having a PGA baby. The authors estimate that each expected month reduces this risk by 5%.

Wait 24.5 months after surgery

Thus, this study shows that the optimal waiting time between the bariatric surgery and the pregnancy is 24.5 months. Among them there is a 15 times greater risk of giving birth to a PGA child. The risks for infants who are small for gestational age are manifold. In fact, they can present at birth with hypothermia, hypoglycemia, infections, or neonatal asphyxia.

Therefore, maintaining a time interval of 24.5 months between surgery and conception has a significant impact on the infant’s weight and health. In fact, a long interval allows women to stabilize their weight loss and nutritional status. The authors explain that the increased risk of neonatal PGA could be related to the rapid weight loss in the mother after bariatric surgery. This would complicate the expected weight gain during pregnancy. Also, this rapid weight loss would lead to nutritional deficiencies that could affect the health of the unborn child.

It is therefore important that women undergo bariatric surgery Be aware of the risks of conceiving early and the benefits of delaying it pregnancy.

Alexia F., Doctor of Neuroscience

Sources

– Pregnancy after bariatric surgery: consensus recommendations for conception preparation, prenatal care and postnatal care. onlinelibrary.wiley.com. Retrieved May 10, 2022.
– Women are advised to wait at least two years after weight loss surgery before attempting to have a baby. easy.org. Retrieved May 10, 2022.
– Obesity in adults: drug and surgical treatment. ameli.fr. Retrieved May 10, 2022.

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