Body weight changes and outcome of pregnancy after gastroplasty for morbid obesity.
BACKGROUND
Pregnancy is usually contraindicated in the first 18 months after anti-obesity operations because of nutritional risk, but childbearing happens nonetheless, both before and after this period.


OBJECTIVE
Aiming to document clinical outcome for mother and child, a retrospective study was undertaken.


METHODS
Women submitted to gastroplasty who conceived after 0-5 years (n=14) were investigated. Calorie intake, maternal and neonatal weight profile, peripartum complications, and clinical course were documented.


RESULTS
Age was 31.8+/-6.5 years, and conception occurred within 24.2+/-21.6 months. BMI before operation, in the first trimester of pregnancy, and about 42 months after operation was respectively 49.9+/-7.9, 35.8+/-5.5 and 34.7+/-11.0 kg/m(2). Energy but not protein ingestion during pregnancy was appropriate, and pregnancy weight gain was scattered along a wide range. Infants (n=16) were born with adequate gestational age (35.6+/-3.3 weeks), weight (3.2+/-0.5 kg) and Apgar score (8.1+/-0.8), and subsequent clinical course was favorable. However cesarean section was required by 64%, and unexpected maternal complications were registered.


CONCLUSIONS
1) Dietary compliance during pregnancy was not optimal, mean weight gain was high, and patients displayed various comorbidities, but infants were born in good conditions; 2) follow-up during 1-3 years pointed out that neonates grew normally, despite continuing maternal high-risk status; and 3) nutritional monitoring should be a priority and dietary guidelines are in clear demand, as current recommendations are sketchy or insufficiently tested within this context.
Dias
Maria Carolina Gonçalves
MC
Division of Nutrition and Dietetics, Hospital das Clinicas, São Paulo 05403-900, Brazil. carolgdias@uol.com.br
Fazio
Eliener de Souza
Ede S
de Oliveira
Fernanda Castello Branco Mariz
FC
Nomura
Roseli Mieko Yamamoto
RM
Faintuch
Joel
J
Zugaib
Marcelo
M
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult