title: Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study.
abstract: BACKGROUND
  Bariatric surgery (BS) has become more frequent among women of child-bearing age. Data regarding the underlying maternal and perinatal risks are scarce. The objective of this nationwide study is to evaluate maternal and perinatal outcomes after BS.
  
  
  METHODS
  We performed a retrospective observational study of 168 pregnancies in 112 women who underwent BS in 10 tertiary hospitals in Spain over a 15-year period. Maternal and perinatal outcomes, including gestational diabetes mellitus (GDM), pregnancy-associated hypertensive disorders (PAHD), pre-term birth cesarean deliveries, small and large for gestational age births (SGA, LGA), still births, and neonatal deaths, were evaluated. Results were further compared according to the type of BS performed: restrictive techniques (vertical-banded gastroplasty, sleeve gastrectomy, and gastric banding), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion (BPD).
  
  
  RESULTS
  GDM occurred in five (3 %) pregnancies and there were no cases of PAHD. Women whose pregnancies occurred before 1 year after BS had a higher pre-gestational body mass index (BMI) than those who got pregnant 1 year after BS (34.6 ± 7.7 vs 30.4 ± 5.3 kg/m(2), p = 0.007). In pregnancies occurring during the first year after BS, a higher rate of stillbirths was observed compared to pregnancies occurring after this period of time (35.5 vs 16.8 %, p = 0.03). Women who underwent BPD delivered a higher rate of SGA babies than women with RYGB or restrictive procedures (34.8, 12.7, and 8.3 %, respectively).
  
  
  CONCLUSIONS
  Pregnancy should be scheduled at least 1 year after BS. Malabsorptive procedures are associated to a higher rate of SGA births.
authors.affiliation: Hospital Juan Ramón Jiménez, Ronda Exterior Norte s/n 21005, Huelva, Spain, Irenegonzalez1@gmail.com.
authors.forename: Irene
authors.initials: I
authors.lastname: González
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rubio
authors.forename: Fernando
authors.initials: F
authors.lastname: Cordido
authors.forename: Irene
authors.initials: I
authors.lastname: Bretón
authors.forename: María J
authors.initials: MJ
authors.lastname: Morales
authors.forename: Nuria
authors.initials: N
authors.lastname: Vilarrasa
authors.forename: Susana
authors.initials: S
authors.lastname: Monereo
authors.forename: Albert
authors.initials: A
authors.lastname: Lecube
authors.forename: Assumptas
authors.initials: A
authors.lastname: Caixàs
authors.forename: Irene
authors.initials: I
authors.lastname: Vinagre
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.forename: Pedro P
authors.initials: PP
authors.lastname: García-Luna
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009767:Obesity, Morbid / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013030:Spain