Bariatric surgeries are increasingly common in France. It particularly affects women of childbearing age. A recent study reveals that it is preferable to wait at least 2 years after a bariatric surgery undertake a pregnancy. Indeed, the operation can have serious consequences for newborns if the delay is too short. Explanations.
Bariatric surgery, more and more widespread
Surgeries for obesity, or bariatric surgeries, are used in cases of extreme obesity. They are experiencing rapid development in France with nearly 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 in case of complications such as type 2 diabetes, hypertension or sleep apnea syndrome;
- Age between 18 and 60 years;
- Have no psychological contraindications;
- It does not present particular operational risks.
Bariatric surgeries combine several operative techniques. They are performed laparoscopically. These operations are not insignificant and require good physical and psychological preparation:
- Restrictive surgical procedures that limit the ability to ingest food. They aim to reduce the volume that food could receive. This may involve fitting an adjustable gastric band or partial removal of the stomach (Sleeve gastrectomy);
- The combined operations combine gastric restriction with the creation of a digestive tract bypass (ring road).
They are increasingly common in women of childbearing age. In fact, they reduce the risks associated with obesity during pregnancy such as preeclampsia or gestational diabetes.
Impact of bariatric surgery on pregnancy
Doctors from Coimbra University Hospital in Portugal wanted to study the impact of bariatric surgery on pregnancy. In particular, they studied the effect 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 occurred after bariatric surgery.
The women included in the study were on average 34.3 years old at the time of delivery. Their mean BMI was 30.9. These women underwent different types of bariatric surgery (gastric bypass, sleeve gastrectomy, gastric band, or biliopancreatic diversion). Furthermore, in 14.6% of cases the delivery took place less than 12 months after surgery, in 14.6% of cases between 12 and 24 months later and 70.8% of deliveries took place more than 2 years after.
The study results reveal that 26.3% of babies were born too small for their gestational age (PGA). Notably, the period between surgery and conception was significantly shorter in PGA infants. Furthermore, analyzes show that the longer the woman waits to conceive, the lower the risk of having a PGA baby. The authors estimate that each projected month reduces this risk by 5%.
Wait 24.5 months after the operation
Therefore, this study shows that the optimal waiting period between the bariatric surgery and the pregnancy is 24.5 months. Below, there is a 15 times greater risk of giving birth to a PGA baby. The risks to gestational age infants are manifold. In fact, they can present at birth with hypothermia, hypoglycemia, infections or neonatal asphyxia.
Therefore, adhering to a time interval of 24.5 months between surgery and conception has a significant impact on the weight and health of the baby. Indeed, a long interval allows women to stabilize their weight loss and nutritional status. Therefore, the authors explain that the increased risk of neonatal PGA could be related to the mother’s rapid weight loss after bariatric surgery. This would make the expected weight gain during pregnancy difficult. Furthermore, this rapid weight loss would lead to nutritional deficiencies that could impact the health of the unborn baby.
It is therefore important that women suffer bariatric surgery be aware of the risk of early conception and the benefits of delaying pregnancy.
Alexia F., Doctor of Neuroscience
– Women are advised to wait at least two years after weight loss surgery before trying to have a baby. easo.org. Accessed May 10, 2022.
– Obesity in adults: drug and surgical treatment. ameli.fr. Accessed May 10, 2022.