Clinical Practice Guidelines for Childbearing Female Candidates for Bariatric Surgery, Pregnancy, and Post-partum Management After Bariatric Surgery

  • Cécile CianguraEmail author
  • Muriel Coupaye
  • Philippe Deruelle
  • Géraldine Gascoin
  • Daniela Calabrese
  • Emmanuel Cosson
  • Guillaume Ducarme
  • Bénédicte Gaborit
  • Bénédicte Lelièvre
  • Laurent Mandelbrot
  • Niccolo Petrucciani
  • Didier Quilliot
  • Patrick Ritz
  • Geoffroy Robin
  • Agnès Sallé
  • Jean Gugenheim
  • Jacky Nizard
  • BARIA-MAT Group


Emerging evidence suggests that bariatric surgery improves pregnancy outcomes of women with obesity by reducing the rates of gestational diabetes, pregnancy-induced hypertension, and macrosomia. However, it is associated with an increased risk of a small-for-gestational-age fetus and prematurity. Based on the work of a multidisciplinary task force, we propose clinical practice recommendations for pregnancy management following bariatric surgery. They are derived from a comprehensive review of the literature, existing guidelines, and expert opinion covering the preferred type of surgery for women of childbearing age, timing between surgery and pregnancy, contraception, systematic nutritional support and management of nutritional deficiencies, screening and management of gestational diabetes, weight gain during pregnancy, gastric banding management, surgical emergencies, obstetrical management, and specific care in the postpartum period and for newborns.


Pregnancy Bariatric surgery Obstetrical management Nutritional management Guidelines 



The authors thank each member of the multidisciplinary reading group, Olivier Ziegler MD, PhD (Department of Diabetology-Endocrinology-Nutrition, CHRU Nancy, University of Lorraine, Nancy, France and president of the national coordination and consultation group of specialized obesity treatment centers), and Jean-Michel Oppert MD, PhD (Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Nutrition, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France).

French Study Group for Bariatric Surgery and Maternity including all listed authors and Virginie Castera, MD1, Régis Coutant, MD, PhD2, Thierry Dupré, MD3, Hubert Johanet, MD4, Marie Pigeyre, MD, PhD5, Brigitte Rochereau, MD6, Véronique Taillard, MD7, Claudine Canale8, Anne-Sophie Joly8

1Department of Endocrinology, St Joseph Hospital, Marseille, France

2Department of Pediatrics, Angers University Hospital, Angers, France

3Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Department of Biochemistry, Paris, France; Société Française des Vitamines et Biofacteurs

4Clinique Turin, Paris, France

5Department of Nutrition, CHRU Lille, University Lille, Lille, France

6Antony, France

7Department of Nutrition, CHU Nimes, Nimes, France

8Collectif National des Associations d’Obèses (CNAO)

Compliance with Ethical Standards

Conflict of Interest

E.C. declares personal fees from Astra Zeneca, Lifescan, Medtronic, MSD, personal fees and non-financial support from Novartis, Novo-Nordisk, Lilly, Roche Diagnostics, Sanofi, Abbott, Orkyn, grants from Fondation Roche, Air liquide, outside the submitted work. G.R. declares personal fees from MSD laboratory Merck-Serono Laboratory, Ferring Laboratory, Teva Laboratory, outside the submitted work. All other authors declare no conflict of interest.

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Cécile Ciangura
    • 1
    Email author
  • Muriel Coupaye
    • 2
    • 3
  • Philippe Deruelle
    • 4
    • 5
  • Géraldine Gascoin
    • 6
    • 7
  • Daniela Calabrese
    • 8
  • Emmanuel Cosson
    • 9
    • 10
  • Guillaume Ducarme
    • 11
  • Bénédicte Gaborit
    • 3
    • 12
  • Bénédicte Lelièvre
    • 13
  • Laurent Mandelbrot
    • 14
  • Niccolo Petrucciani
    • 15
  • Didier Quilliot
    • 16
    • 17
  • Patrick Ritz
    • 18
  • Geoffroy Robin
    • 5
    • 19
  • Agnès Sallé
    • 20
  • Jean Gugenheim
    • 21
    • 22
  • Jacky Nizard
    • 23
  • BARIA-MAT Group
  1. 1.Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Departments of Nutrition and Diabetology, Institute of Cardiometabolism and Nutrition (ICAN)Sorbonne UniversityParisFrance
  2. 2.Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Explorations Fonctionnelles, ColombesUniversity Paris DiderotParisFrance
  3. 3.Association Française d’Etude et de Recherche sur l’Obésité (AFERO)ParisFrance
  4. 4.Department of Obstetrics and GynecologyStrasbourg University HospitalStrasbourgFrance
  5. 5.Collège National des Gynécologues et Obstétriciens Français (CNGOF)ParisFrance
  6. 6.Department of Neonatal MedicineAngers University HospitalAngersFrance
  7. 7.Société Française de Néonatologie et Société Française de PédiatrieParisFrance
  8. 8.Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Digestive Surgery, ColombesUniversity Paris DiderotParisFrance
  9. 9.Assistance Publique-Hôpitaux de Paris, Jean Verdier Hospital, Department of Endocrinology-Diabetology-Nutrition, Bondy, 10 UMR U557 INSERM/U11125 INRA/CNAMUniversity Paris13BobignyFrance
  10. 10.Société Francophone du Diabète (SFD)ParisFrance
  11. 11.Department of Obstetrics and GynecologyDepartemental HospitalLa Roche-sur-YonFrance
  12. 12.Assistance Publique-Hôpitaux de Marseille, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, INSERM, INRA, C2VNAix Marseille UniversityMarseilleFrance
  13. 13.Laboratory of Pharmacology and ToxicologyAngers University HospitalAngersFrance
  14. 14.Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Gynecology and Obstetrics, ColombesUniversity Paris DiderotParisFrance
  15. 15.Assistance Publique-Hôpitaux de Paris, Henri Mondor Hospital, Division of Digestive Surgery and Liver TransplantationUPEC UniversityCréteilFrance
  16. 16.Department of Diabetology-Endocrinology-Nutrition, CHRU Nancy, INSERM 954University of LorraineNancyFrance
  17. 17.Société Francophone Nutrition Clinique et Métabolisme (SFNCM)ParisFrance
  18. 18.Department of Endocrinology, Metabolic Diseases and Nutrition, Toulouse University Hospital, UMR1027Paul Sabatier UniversityToulouseFrance
  19. 19.Department of Medical Gynecology, and Sexology and Department of Assisted Reproductive Technologies and Fertility Preservation, Jeanne de Flandre Hospital, Lille, EA4308 “gametogenesis and gamete quality”Lille UniversityLilleFrance
  20. 20.Department of Diabetology-Endocrinology-NutritionAngers University HospitalAngersFrance
  21. 21.Division of Digestive Surgery and Liver TransplantationNice University Hospital, University of NiceNiceFrance
  22. 22.Société Française et Francophone de Chirurgie de l’Obésité et des Maladies Métaboliques (SOFFCOMM)Porte des Pierres DoréesFrance
  23. 23.Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Gynecology and ObstetricsSorbonne UniversityParisFrance

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