Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges.
With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstetrical and perinatal implications of pregnancy following BS.


METHODS
English, Spanish and Portuguese-language articles were identified in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding.


RESULTS
The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauterine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery-to-conception interval. Deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium can result in maternal and fetal complications.


CONCLUSIONS
Pregnancy outcome of women who delivered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can prevent nutrition-related complications and improve maternal and fetal health.
Department of Medical Psychology and Psychiatry, State University of Campinas, Rua Padre Almeida 515, sala 14, Campinas, SP CEP: 13025-251, Brazil. ronism@uol.com.br
Ronis
R
Magdaleno
Belmiro Gonçalves
BG
Pereira
Elinton Adami
EA
Chaim
Egberto Ribeiro
ER
Turato
D050110:Bariatric Surgery / Q000009:adverse effects* / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D003677:Deficiency Diseases / Q000453:epidemiology / Q000209:etiology*; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005298:Fertility; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D012306:Risk