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Weight recurrence after sleeve gastrectomy negatively impacts pregnancy

Weight recurrence after sleeve gastrectomy (SG) negatively impacts pregnancy and increases the probability of several complications for the mother and foetus, particularly anaemia, gestational diabetes mellitus (GDM) and postpartum haemorrhage (PPH), according to researchers from Saudi Arabia.

The study’s authors noted that the rate of obesity among females (33.5%) is greater than that of males in Saudi (24.1%) and 80% of patients who undergo BSs are women of childbearing age. It is known that fertility in women with obesity generally improves after bariatric surgery, as ovulatory problems and menstrual irregularities often resolve after weight loss. However, during pregnancy obesity is correlated with higher risks for numerous complications, including GDM, pregnancy-associated HTN and pre-eclampsia, preterm birth, failure to progress in labour, a caesarean delivery, complications related to macrosomia, venous thromboembolism, infection, depression, congenital anomalies, mortality, prematurity and large for gestational age (LGA) neonates. In addition, studies show the benefits of a bariatric surgery in reducing the complications related to obesity that may affect pregnancy and neonatal outcomes.


Nevertheless, the authors noted that no previous studies have been performed in Saudi Arabia to assess the impact of SG on pregnancy outcomes. Therefore, the aim of their study was to estimate the consequence of SG and its relationship with pregnancy outcomes in women in Saudi Arabia. Furthermore, they also explored the possible complications that develop for the mother and the foetus after gaining weight following bariatric surgery.


Outcomes

The study was conducted in Saudi Arabia between February 2023 and May 2023 among 245 women who became pregnant after undergoing SG. In total, 4.9% of studied females were smoking during pregnancy. Of them, 20% had chronic diseases, with diabetes (38.7%) and hypertension (34.6%) being the most common. The mean weight at the beginning of pregnancy was 46.52±16.01 kg, the mean weight gain during pregnancy was 15.62±16.48 kg, and the mean weight last measured before birth was 74±15.731kg. Of the participants, 78.8% had anaemia during pregnancy.


In total, 78% of females had a normal non-induced type of delivery and 58% had a vaginal birth. Of them, 18% had complications during and immediately after childbirth, with PPH being the most common (43.1%). The mean baby weight at birth was 3.08±1.42 kg and 23.7% of babies had complications with being SGA as the most common complication (60.3%, Figure 1).

Figure 1: Percentage distribution of studied females according to prevalence and types of child complications (neonatal intensive care unit)

Females who were smoking during pregnancy had a significantly higher percentage of having pre-eclampsia, having a child with complications and having a baby SGA (p≤0.05). Conversly, a non-significant relationship was found between having any comorbidity and pregnancy disorders, type of delivery and mode of delivery, complications happening during and immediately after childbirth, and birth weight or child complications (p≥0.05).

Patients with hypertension had a significantly higher percentage of those who suffered from pregnancy disorders (p≤0.05) and participants who had diabetes had a substantially higher rate of having a child who sustained any complications (p≤0.05).


“This study concluded that weight gain after SG negatively impacted pregnancy and increased the probability of several complications for the mother and foetus, particularly anaemia, GDM and PPH. Women must be aware of these preventable harmful events. Furthermore, we reported that smoking is significantly associated with pregnancy-related complications among women who underwent BS, such as pre-eclampsia and having an SGA infant, a modifiable risk factor the mother should stop during pregnancy” the authors write. “Healthcare providers must inform every woman undergoing BS about the possible complication of an unhealthy lifestyle after the procedure that may affect her and her infant.”


The outcomes of the study were published in the paper, ‘The Effect of Sleeve Gastrectomy on Pregnancy Complications: A Cross-Sectional Study in Saudi Arabia’, published in Cureus. To access this paper, please click here


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