Thursday, 26 February 2015

Weight-Loss Surgery May Lower Some Pregnancy Complications, Raise Others


By Maureen Salamon

HealthDay Reporter

WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- After undergoing weight-loss surgery, women are significantly less prone to diabetes during pregnancy but twice as likely to deliver smaller-than-normal infants, a new study suggests.

Swedish scientists found that weight-loss (or "bariatric") surgery before pregnancy lowers the chances of certain complications for mothers and babies but raises the odds for others. They recommended any pregnancy after weight-loss surgery be considered high-risk and receive stricter monitoring.

"The number of women who are obese in early pregnancy has increased dramatically over the last decades," said study author Kari Johansson, a postdoctoral researcher and nutritionist at Karolinska Institute in Stockholm. "Consequently, there has been a dramatic rise in the number of women becoming pregnant after bariatric surgery," she added.

"The positive effects of bariatric surgery on health outcomes -- such as diabetes and cardiovascular disease -- are reasonably well-studied, but less is known about the effects on pregnancy and [post-delivery] outcomes," Johansson pointed out.

The study was published online Feb. 26 in the New England Journal of Medicine.

U.S. health officials say more than one-third of American adults are obese, with a body mass index (BMI, a height-weight calculation) of 30 or higher.

Nearly 179,000 obese people underwent weight-loss surgery in the United States in 2013, according to the American Society for Metabolic and Bariatric Surgery. While various techniques may be used, the surgery restricts the amount of food the stomach can hold and/or reduces the intestines' absorption of calories and nutrients from food.

Johansson and her colleagues used data from nationwide Swedish health registries to compare pregnancies between nearly 600 women who had given birth after bariatric surgery and more than 2,300 women who hadn't had the surgery but had the same BMI.

Only 2 percent of women who had weight-loss surgery developed gestational diabetes, compared to 7 percent of the other group, the researchers said. The surgical group was also much less likely to give birth to larger-than-normal babies.

However, the weight-loss surgery group was twice as likely to give birth to babies considered small for their gestational age, and their pregnancies were also of slightly shorter duration. Additionally, the surgical group experienced a slight bump in the rate of stillbirths, the study found.

source : Weight-Loss Surgery May Lower Some Pregnancy Complications, Raise Others

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