Lifestyle after bariatric surgery: a multicenter, prospective cohort study in pregnant women.
BACKGROUND
To ensure a good pregnancy outcome after bariatric surgery, a healthy life-style and a multidisciplinary prenatal follow-up is recommended. The aim of this prospective multicenter trial was to compare diet quality and physical activity (PA) of pregnant women with bariatric surgery with current lifestyle recommendations.


METHODS
Pregnant women (>18 years, prepregnancy BMI 28 ± 6 kg/m², 39 % nulliparae, 25 % smokers) with a history of bariatric surgery were recruited and allocated to two groups according to surgery type: restrictive (N = 18) and bypass group (N = 31). One 7-day dietary record and one Kaiser questionnaire on PA were collected during the first and second trimester. Dietary quality was assessed using the Healthy Eating Index.


RESULTS
The diet quality did not change during pregnancy (restrictive group p = 0.050; bypass group p = 0.975) and was comparable between groups (first trimester p = 0.426; second trimester p = 0.937). During the first trimester, 15 % of the pregnant women had a healthy diet quality, 82 % had a diet that needed improvement, and 3 % had a poor diet quality. This was independent of surgery type and was comparable in the second trimester (p = 0.525). No difference between groups was observed for the PA level, but the PA level in the bypass group significantly decreased from the first to the second trimester (p = 0.033).


CONCLUSIONS
Nutritional advice and lifestyle coaching in this high-risk population seems recommendable since only 15 % of the pregnant women had a healthy diet quality, 25 % was smoking at the beginning of pregnancy, and the reported PA levels were low.
Department of Nutrition-Public Health Medicine, Catholic University Leuven, Leuven, Belgium.
I
I
Guelinckx
R
R
Devlieger
P
P
Donceel
S
S
Bel
S
S
Pauwels
A
A
Bogaerts
I
I
Thijs
K
K
Schurmans
P
P
Deschilder
G
G
Vansant
D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D001530:Belgium / Q000453:epidemiology; D015331:Cohort Studies; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D009043:Motor Activity; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult