Body weight changes and outcome of pregnancy after gastroplasty for morbid obesity

SummaryBackgroundPregnancy is usually contraindicated in the first 18 months after anti-obesity operations because of nutritional risk, but childbearing happens nonetheless, both before and after this period.ObjectiveAiming to document clinical outcome for mother and child, a retrospective study was undertaken.MethodsWomen submitted to gastroplasty who conceived after 0–5 years (n = 14) were investigated. Calorie intake, maternal and neonatal weight profile, peripartum complications, and clinical course were documented.ResultsAge was 31.8 ± 6.5 years, and conception occurred within 24.2 ± 21.6 months. BMI before operation, in the first trimester of pregnancy, and about 42 months after operation was respectively 49.9 ± 7.9, 35.8 ± 5.5 and 34.7 ± 11.0 kg/m2. Energy but not protein ingestion during pregnancy was appropriate, and pregnancy weight gain was scattered along a wide range. Infants (n = 16) were born with adequate gestational age (35.6 ± 3.3 weeks), weight (3.2 ± 0.5 kg) and Apgar score (8.1 ± 0.8), and subsequent clinical course was favorable. However cesarean section was required by 64%, and unexpected maternal complications were registered.Conclusions1) Dietary compliance during pregnancy was not optimal, mean weight gain was high, and patients displayed various comorbidities, but infants were born in good conditions; 2) follow-up during 1–3 years pointed out that neonates grew normally, despite continuing maternal high-risk status; and 3) nutritional monitoring should be a priority and dietary guidelines are in clear demand, as current recommendations are sketchy or insufficiently tested within this context.