title: Pregnancy After Bariatric Surgery: National Survey of Obstetrician's Comfort, Knowledge, and Practice Patterns.
abstract: The objective of this study is to survey a nationally representative sample of obstetricians regarding comfort, knowledge, and practice patterns of caring for pregnant women after bariatric surgery.
  
  
  
  We conducted an online survey of US obstetricians and describe obstetrician's demographics, practice settings, and practice patterns. We assessed respondent's knowledge and recommended practices. We compared provider knowledge by years since completing residency, scope of practice (generalist or specialist), and practice setting (academic setting or other). Statistical significance was set at p < 0.05.
  
  
  
  A total of 106 completed the survey (response rate of 54%). Respondents had a median age of 47 and median 17 years in practice. Sixty-two percent were generalists. Nearly all of the respondents (94%) had some experience with caring for pregnant women after bariatric surgery and 83% reported feeling "very comfortable" (48%) or "somewhat comfortable" (35%) providing care for this population. Most (74%) were aware of increased risk of small for gestational age after surgery. Only 13% were able to correctly identify all recommended nutritional labs and 20% reported that they "did not know" which labs are recommended. There were no differences in comfort, experience, knowledge, and practice patterns by physician characteristics and practice settings.
  
  
  
  While most obstetricians are aware of perinatal risks after bariatric surgery, a substantial percentage of obstetricians are unaware of recommended practices regarding nutrition and nutritional monitoring. As bariatric surgery becomes increasingly prevalent among reproductive age women, educational interventions to increase obstetricians' knowledge of optimal care of pregnant women after bariatric surgery are urgently needed.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA. Marcela.Smid@hsc.utah.edu.|Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, 50 North Medical Drive, Suite 2B200, Salt Lake City, UT, 84132, USA. Marcela.Smid@hsc.utah.edu.
authors.forename: Marcela C
authors.initials: MC
authors.lastname: Smid
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Dotters-Katz
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA.
authors.forename: Cora-Ann
authors.initials: CA
authors.lastname: Mcelwain
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, University of Utah Salt Lake City, Salt Lake City, UT, USA.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Volckmann
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stuebe
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D050110:Bariatric Surgery / Q000009:adverse effects / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000534:rehabilitation* / Q000601:surgery*; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D011256:Pregnancy Outcome / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Bariatric surgery; Gastric bypass; Obesity; Pregnancy; Weight loss surgery