Weight Loss Surgery Helps Obese Women Have Healthier Pregnancies, Infants

Main Category: Obesity / Weight Loss / Fitness
Also Included In: GastroIntestinal / Gastroenterology;  Pregnancy / Obstetrics;  Pediatrics / Children's Health
Article Date: 24 Nov 2008 - 6:00 PST

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Women who become pregnant after undergoing bariatric surgery have less complicated pregnancies and healthier infants than obese women who become pregnant, according to a new study, the New York Times reports. The new research -- which reviewed 75 earlier studies -- found that pregnant women who have lost weight after bariatric surgery may have lower rates of pregnancy complications such as gestational diabetes and pre-eclampsia and do almost as well as women who are not obese, the Times reports. In addition, their infants are healthier and may be less likely to be born too small or prematurely. According to the authors, fertility seemed to improve after surgery as hormone levels and menstrual cycles returned to normal.

The Times reports that about one-third of U.S. women are obese, and they usually are advised to lose weight before becoming pregnant because they have a high risk for developing pregnancy-related health problems. For example, their infants are more likely to be born prematurely or stillborn, to be very large, or to have a neural tube defect. Melinda Maggard, a general surgeon at the University of California-Los Angeles and an author of the study, said, "Intuitively, it makes sense to me that the maternal outcomes are better after bariatric surgery -- they lose weight and approach the outcomes of normal women." However, considering that more than 50,000 young women have bariatric surgery every year, Maggard said more research into the effects of the surgery is needed. Laura Riley, medical director of labor and delivery at Massachusetts General Hospital, said that morbidly obese patients often attempt to lose 10 or 15 pounds, "but the majority don't lose the weight and just come back pregnant." She added, "With this kind of data, it's easier to say, 'You are better off having bariatric surgery and losing 100 pounds and then getting pregnant.'"

According to Maggard, one of the most urgent unresolved questions regarding bariatric surgery has to do with the effectiveness of oral contraceptives in women who have had the procedure. Currently, no randomized trials have assessed the efficacy of birth control pills after bariatric procedures, including ones that affect the absorption of drugs and nutrients. Maggard said, "Until we have some better answers about oral contraceptives, women should consider other methods, such as barrier methods, to prevent unwanted pregnancies." She added that women who had had the surgery should "defer pregnancy until after the time of rapid weight loss," or about one year (Rabin, New York Times, 11/20).

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