The time interval between bariatric surgery and pregnancy is controversial. In this study, we report and compare the outcomes of pregnancy from two groups of bariatric surgery (BS) patients who became pregnant less than 12 months (early) and above 12 months (late) after surgery.
Materials and Methods
For this retrospective study, women of reproductive age who became pregnant after BS between 2010 and 2019 were reviewed, allocated into two groups, and compared. Perinatal care was provided as standards and continued at monthly intervals by a gynecologist. Demographic data, pregnancy-related events, results of any screening tests in each trimester, the reports of all ultrasonographies, and lab data were extracted from their medical documents. Chi-square and t-test were used for analysis.
Four hundred seventy-seven out of 1046 participants were of reproductive age. 12 and 37 women were put in early and late pregnancy groups, respectively. No significant difference was observed in the rate of maternal complications, outcomes of pregnancies, and the rate of fetal and neonatal problems in pregnancies conceived during the first vs. second year postbariatric surgery. 91.6% of the patients with early pregnancy had at least one perinatal/neonatal finding. Mean neonatal birth weight was 2610 ± 152 and 2881 ± 315 g in early and late pregnancy groups, respectively. Patients with early pregnancy were not at significantly higher odds for any pregnancy-related or neonatal complications.
The rate of maternal, fetal, and neonatal complications in pregnancies conceived during the first vs. second postbariatric year were indifferent.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Waitzberg DL, Correia MI. Strategies for high-quality nutrition therapy in Brazil. J Parenter Enter Nutr Wiley Online Library. 2016;40:73–82.
Khalaj A, Ghadimi F, Valizadeh M, et al. Successful pregnancy and weight loss management in a woman unknowingly pregnant at the time of bariatric surgery: a case report. BMC Pregnancy Childbirth. Springer. 2020;20:94.
Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, Hjelmesæth J, Kinzl J, Leitner DR, Makaronidis JM, Schindler K, Toplak H, Yumuk V Practical recommendations of the obesity management task force of the European Association for the Study of obesity for the post-bariatric surgery medical management. Obes Facts. Karger Publishers; 2017;10:597–632.
Johnson EE, Simpson AN, Harvey JB, et al. Trends in bariatric surgery, 2002–2012: do changes parallel the obesity trend? Surg Obes Relat Dis. Elsevier. 2016;12:398–404.
Willis K, Lieberman N, Sheiner E. Pregnancy and neonatal outcome after bariatric surgery. Best Pract Res Clin Obstet Gynaecol. Elsevier. 2015;29:133–44.
Adams TD, Hammoud AO, Davidson LE, et al. Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. Int J Obes Nature Publishing Group. 2015;39:686–94.
Amsalem D, Aricha-Tamir B, Levi I, et al. Obstetric outcomes after restrictive bariatric surgery: what happens after 2 consecutive pregnancies? Surg Obes Relat Dis Elsevier. 2014;10:445–9.
Parent B, Martopullo I, Weiss NS, et al. Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications. JAMA Surg. American Medical Association. 2017;152:128–35.
Reynolds RM, Allan KM, Raja EA, Bhattacharya S, McNeill G, Hannaford PC, et al. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years. Bmj. British Medical Journal Publishing Group; 2013;347:f4539.
Keleidari B, Mahmoudieh M, Shahabi S, Sheikhbahaei E, Rezaei M, Sayadi M, et al. Reversing one-anastomosis gastric bypass surgery due to severe and refractory hypoalbuminemia. World J Surg [Internet]. Springer International Publishing; 2020;44:1200–8. Available from: doi:https://doi.org/10.1007/s00268-019-05290-7
Keleidari B, Mahmoudieh M, Gorgi K, et al. Hepatic failure after bariatric surgery: A systematic review. Hepat Mon. 2019;19:1–16.
Sayadi Shahraki M, Khalili N, Yousefvand S, Sheikhbahaei E, Shahabi Shahmiri S. Severe obesity and vitamin D deficiency treatment options before bariatric surgery: a randomized clinical trial. Surg Obes Relat Dis [Internet]. Elsevier Inc.; 2019;15:1604–11. Available from: doi:https://doi.org/10.1016/j.soard.2019.05.033
Allen LH. Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr. Oxford University Press. 2005;81:1206S–12S.
Nomura RMY, Dias MCG, Igai AMK, et al. Anemia during pregnancy after silastic ring Roux-en-Y gastric bypass: influence of time to conception. Obes Surg. United States. 2011;21:479–84.
Vannevel V, Jans G, Bialecka M, et al. Internal herniation in pregnancy after gastric bypass: a systematic review. Obstet Gynecol. LWW. 2016;127:1013–20.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient - 2013 update: Cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society. Surg Obes Relat Dis. Elsevier. 2013;9:159–91.
Busetto L, Dicker D, Azran C, et al. Obesity management task force of the European Association for the study of obesity released “Practical Recommendations for the Post-Bariatric Surgery Medical Management”. Obes Surg Springer. 2018;28:2117–21.
Rasteiro C, Araújo C, Cunha S, et al. Influence of time interval from bariatric surgery to conception on pregnancy and perinatal outcomes. Obes Surg. Springer. 2018;28:3559–66.
Brönnimann A, Jung MK, Niclauss N, et al. The impact of pregnancy on outcomes after bariatric surgery. Obes Surg. 2020;30:3001–9.
Sheiner E, Edri A, Balaban E, et al. Pregnancy outcome of patients who conceive during or after the first year following bariatric surgery. Am J Obstet Gynecol. Elsevier. 2011;204:50–e1.
Kjær MM, Nilas L. Timing of pregnancy after gastric bypass—a national register-based cohort study. Obes Surg. Springer. 2013;23:1281–5.
Sancak S, Çeler Ö, Çırak E, et al. Timing of gestation after laparoscopic sleeve gastrectomy (LSG): does it influence obstetrical and neonatal outcomes of pregnancies? Obes Surg. 2019;29:2629–30.
Dolin CD, Chervenak J, Pivo S, Ude Welcome A, Kominiarek MA. Association between time interval from bariatric surgery to pregnancy and maternal weight outcomes. J Matern Neonatal Med [Internet]. Taylor & Francis; 2019;0:1–8. Available from: doi:https://doi.org/10.1080/14767058.2019.1683156
Malakauskienė L, Nadišauskienė RJ, Ramašauskaitė D, Bartusevičienė E, Ramonienė G, Maleckienė L. Is it necessary to postpone pregnancy after bariatric surgery: a national cohort study. J Obstet Gynaecol (Lahore) [Internet]. Taylor & Francis; 2020;40:614–8. Available from: doi:https://doi.org/10.1080/01443615.2019.1634024
Wax JR, Cartin A, Wolff R, et al. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes Surg Springer. 2008;18:1517–21.
Rottenstreich A, Elazary R, Elchalal U, et al. Time to conception after sleeve gastrectomy and associated pregnancy outcomes—a careful look at the evidence. Obes Surg. Obesity Surgery. 2019;29:2627–8.
Keleidari B, Mahmoudieh M, Kafi S, Shahabi S, Sheikhbahaei E, Farahmand A, et al. Which one is better for non-alcoholic fatty liver disease, the Roux-en-Y gastric bypass or one anastomosis gastric bypass? A paired liver biopsy report. Obes Med [Internet]. Elsevier Ltd; 2020;18:100205. Available from: doi:https://doi.org/10.1016/j.obmed.2020.100205
Mahmoudieh M, Keleidari B, Afshin N, et al. The early results of the laparoscopic mini-gastric bypass/one anastomosis gastric bypass on patients with different body mass index. J Obes. 2020;2020:1–6.
Mahmoudieh M, Keleidari B, Salimi M, Sayadi M, Shahabi S, Sheikhbahaei E. The two different biliopancreatic limb lengths for Roux-en-Y gastric bypass. Obes Med [Internet]. Elsevier; 2019;16:100146. Available from: doi:https://doi.org/10.1016/j.obmed.2019.100146
Parikh R, Lavoie M, Wilson L, et al. Timing of pregnancy after bariatric surgery. Obstet Gynecol. LWW. 2014;123:165S.
Yi X, Li Q, Zhang J, et al. A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery. Int J Gynecol Obstet. Elsevier. 2015;130:3–9.
Patel JA, Patel NA, Thomas RL, et al. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. Elsevier. 2008;4:39–45.
Dao T, Kuhn J, Ehmer D, et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. Elsevier. 2006;192:762–6.
Yau PO, Parikh M, Saunders JK, et al. Pregnancy after bariatric surgery: the effect of time-to-conception on pregnancy outcomes. Surg Obes Relat Dis Elsevier. 2017;13:1899–905.
González I, Lecube A, Rubio MÁ, et al. Pregnancy after bariatric surgery: improving outcomes for mother and child. Int J Womens Health. 2016;8:721.
The authors express their gratitude toward Mr. Amir Salar Moazen Safaei for his kind support through this research.
Ethics Approval and Consent to Participate
All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki declarations and its later amendments. For this type of study formal consent is not required.
Consent for Publication
Informed consent was obtained before surgery from all individual participants included in the study.
Conflict of Interest
All authors declare no potential conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Mahmoudieh, M., Keleidari, B., Shahabi, S. et al. Pregnancy Less Than 1 Year After the Bariatric Surgery: Is It Really Safe?. OBES SURG (2021). https://doi.org/10.1007/s11695-021-05260-w
- Bariatric surgery
- Gastric bypass