Pregnancy following bariatric surgery

The obesity epidemic continues to escalate worldwide, making bariatric surgery an increasingly more attractive intervention. Obese women are at increased risk for several serious pregnancy complications, and as more reproductive-age obese women undergo bariatric surgery, new concerns arise regarding the ability of these women to conceive, support and deliver future pregnancies. The purpose of this article is to evaluate the current literature on the impact of surgical weight loss on the maternal and fetal outcomes in future pregnancies. Bariatric surgery seems to improve the altered reproductive hormone profile associated with morbid obesity, and ultimately enhances fertility status. It appears that surgical weight loss helps prevent the development of gestational diabetes and lowers the risk of chronic hypertension, gestational hypertension and preeclampsia in subsequent pregnancies. The effect of bariatric surgery on the mode of delivery and the need for cesarean section is unclear. Although surgical weight loss seems to be a good intervention to lower the risk of macrosomia, it does not seem to increase the risk of low-birth-weight babies or the risk of neural tube defects. Maternal surgical weight loss lowers the prevalence of obesity and cardiometabolic risk factors in the offspring until the adolescent years. The increasing popularity of bariatric surgery in reproductive-age women calls for greater clinician awareness of its impact on future pregnancy outcomes.