title: Bariatric Surgery and the Pregnancy Complicated by Gestational Diabetes.
abstract: Gestational diabetes mellitus (GDM) is an increasingly common obstetrical problem. Due to the global escalation in the prevalence of obesity, as many as 15 % of pregnant women may soon be classified as having GDM. While often not diagnosed until late gestation, GDM is now recognized as a disorder of glucose and lipid metabolism, systemic inflammation, and insulin resistance that begins early in pregnancy. Recent large randomized trials have clarified the risk of maternal and neonatal complications caused by GDM, as well as the potential to ameliorate these risks. There is significant interest in the potential to reduce the risk for developing GDM in obese women through the performance of bariatric surgery (BS) before pregnancy. BS significantly reduces the risk for GDM, preeclampsia, and large neonates. However, it seems that the risk for small neonates and preterm delivery is increased. No significant differences are observed in regard to cesarean section, postpartum hemorrhage, or perinatal mortality. In this article, we address the effects of GDM on the mother and child, and explore the risks and benefits of BS in the obstetrical population.
authors.affiliation: Our Lady of the Lake Children's Hospital, 7777 Hennessy Boulevard, Suite 6003, Baton Rouge, LA, 70808, USA. kent.willis@ololrmc.com.
authors.forename: Kent
authors.identifier: http://orcid.org/0000-0001-7338-0399
authors.initials: K
authors.lastname: Willis
authors.affiliation: The Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Alexander
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva, Israel. sheiner@bgu.ac.il.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence
keywords: Bariatric surgery; Gestational diabetes; Obesity; Pregnancy