January 12, 2013
Weight Loss Surgery Patients: Wait 12 Months Before Attempting Conception
Connie K. Ho for redOrbit.com — Your Universe Online
Researchers in the United Kingdom recently conducted a literature review that revealed women should wait a minimum of 12 months after weight loss surgery before trying to get pregnant.
The review evaluated the advantages, safety, and difficulties of bariatric surgery. It also looked at the multidisciplinary management of patients prior to, during, and after pregnancy. The findings of the review were recently featured in The Obstetrician & Gynaecologist.
"An increasing number of women of child-bearing age are undergoing bariatric surgery procedures and need information and guidance regarding reproductive issues. In light of current evidence available, pregnancy after bariatric surgery is safer, with fewer complications, than pregnancy in morbidly obese women. Multidisciplinary input care is the key to a healthy pregnancy for women who have undergone bariatric surgery,” noted the review´s co-author Rahat Khan, a consultant obstetrician and gynecologist at Princess Alexandra Hospital NHS Trust, in a prepared statement. “However, this group of women should still be considered high risk by both obstetricians and surgeons.”
The study is of importance as obesity has been on the rise among women of reproductive age. The researchers noted the rate of obesity could change from 24.2 percent in 2005 to 28.3 percent in 2015 for that particular demographic. They also found the number of females having bariatric surgery was on the rise, but obesity can increase the risk of possible obstetric complications. As such, the researchers believe pregnancy is safer for women who have had bariatric surgery, as compared to females who are morbidly obese. In particular, a past study showed pregnancies are safe for 79.2 percent of patients following weight loss surgery.
On the other hand, the researchers noted there could be surgical complications during pregnancy that also result after bariatric surgery. A past study discovered there might be band slippage and migration, which causes side effects like vomiting and band leakage. Based on the current evidence, researchers also recommended individuals should not attempt to get pregnant for a minimum of 12 months after undergoing bariatric study. In particular, a past study showed there was a higher rate of spontaneous miscarriage for women who became pregnant within 18 months (31 percent) as compared to women who became pregnant 18 months after undergoing weight loss surgery (18 percent).
Due to these findings, the researchers advised women to consult with their physicians on issues related to nutrition, contraception, weight gain, and vitamin supplementation prior to conception.
"Increasingly, obstetricians, surgeons and primary care clinicians will be required to address questions posed by their patients regarding the safety of pregnancy after weight loss surgery," continued Khan in the statement.
For there to be a healthy maternal and neonatal outcome after weight loss surgery, patients are advised to work with a multidisciplinary team made up of anesthetists, fertility specialists, nutritionists, obstetricians, psychologists, primary care clinicians, and surgeons prior to, during, and after pregnancy.
"Optimal education should be encouraged in these individuals so that they can make well informed decisions about planning pregnancy after their surgery,” said Jason Waugh, TOG´s Editor-in Chief, in the statement.