title: Pregnancy after laparoscopic gastric banding: maternal and neonatal outcomes.
abstract: BACKGROUND
  Laparoscopic Adjustable Gastric Banding (LAGB) is a safe and effective treatment for obesity. A strong evidence links weight loss with improved fertility outcomes and reduced gestational complications in subsequent pregnancies. Our aim is to describe the impact of LAGB on maternal and neonatal outcomes.
  
  
  METHODS
  Data were collected retrospectively from the database of our University Center for the Multicentric Treatment of Severe Obesity. From January 2006 to December 2011, 438 patients underwent LAGB. Of these, 140 women of reproductive age (18-46 years old) were included in our study. The following parameters were registered during follow-up: number of pregnancies, delivery and miscarriage, time from LAGB to pregnancy, band adjustments, weight gain during pregnancy, gestational and obstetrical complications (gestational diabetes mellitus, hypertensive disorders, prolonged labor), mode of delivery, neonatal birth weight and complications (low birth weight, IUGR, prematurity, macrosomy).
  
  
  RESULTS
  We registered 26 pregnancies with a total of 22 babies born and 4 miscarriages. The mean time from LAGB to pregnancy was 15.8 months. Band adjustments were performed in 100% of patients during the first trimester; the average weight gain at the end of pregnancy was 14.66 kg. None presented gestational or obstetrical complications. One patient presented band slippage, which required surgery, and one patient presented iron-deficiency anemia. 100% of deliveries were by cesarean section. No perinatal complications or malformations were recorded, and the average baby weight was 3027 g.
  
  
  CONCLUSIONS
  LAGB is a safe procedure, well tolerated during pregnancy and without negative implications on both the mother and the baby. According to our experience and recent studies, band loosening should be reserved to symptomatic patients to avoid unhealthy weight gain.
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pilone
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy. Electronic address: ariolahasani@libero.it.
authors.forename: Ariola
authors.initials: A
authors.lastname: Hasani
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Di Micco
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vitiello
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Monda
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Izzo
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Leucio
authors.initials: L
authors.lastname: Iacobelli
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Villamaina
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Forestieri
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D009767:Obesity, Morbid / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; Gastric banding; Laparoscopy; Maternal outcomes; Obesity; Pregnancy