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 Because obesity is linked to fertility issues, undergoing so-called
bariatric surgery to shed excess weight can make it easier for some
women to get pregnant. But when these women do conceive, they are
more likely to have premature or small infants that require
intensive care than women in the general population.
“Risks to the infant are highest in the first three years after an
operation, and diminish over time,” said lead study author Dr.
Brodie Parent of the University of Washington in Seattle.
“This suggests that women should wait a minimum of three years after
an operation before attempting conception,” Parent added by email.
Globally, 1.9 billion adults are overweight or obese, according to
the World Health Organization. In addition to its impact on
fertility, obesity also increases the risk of heart disease,
diabetes, joint disorders and certain cancers.
Bariatric surgery can be more effective for lasting weight loss than
alternatives such as dieting or exercising, but it is not risk free.
Like other surgery, there’s a risk of infection, and weight-loss
procedures can also lead to malnutrition.
For the current study, researchers wanted to see how the amount of
time between bariatric surgery and pregnancy influences the risk of
complications for babies.
They analyzed data from birth certificates and hospital records for
1,859 post-operative mothers and their babies, as well as for a
control group of 8,437 randomly selected mothers that were similar
in many ways but didn’t have surgery. Records all came from
Washington state and were collected from 1980 to 2013.
Compared with infants born to women who didn’t have surgery, babies
born after mothers had bariatric procedures were 57 percent more
likely to be premature, 25 percent more likely to be admitted to the
neonatal intensive care unit (NICU) and 93 percent more likely to be
small for their gestational age, researchers report in JAMA Surgery.
Timing appears to explain at least some of this added risk.
For women that had bariatric surgery, babies born less than two
years afterwards were around 50 percent more likely to be premature,
unusually small or spend time in the NICU than infants born at least
four years later.
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One limitation of the study is that researchers lacked data on what
type of bariatric surgery women had, the authors note. Different
procedures have varying effects on metabolism, hormonal balance and
the odds of malnutrition, the authors point out.
Another drawback is that for many women in the study, researchers
lacked data on weight or how many pounds were shed after surgery,
making it possible that some complications linked to surgery might
be connected to lingering obesity, the authors also explain.
The study also leaves a key question unanswered – whether obese
women who have surgery wind up with a higher or lower risk for
complications with their babies than they would have had without
these operations, Dr. Aaron Dawes of the David Geffen School of
Medicine at the University of California, Los Angeles, writes in an
accompanying editorial.
Obesity alone puts women at risk for complications with their
babies, Dawes told Reuters Health.
“We know that maintaining a healthy weight is important both to
becoming pregnant and to delivering a healthy baby,” Dawes added by
email. “What we don't yet know is what the safest way is to achieve
this weight and whether obese women who take steps to lose weight
through surgery also put themselves and their children at risk.”
SOURCE: http://bit.ly/2eGdIZu and http://bit.ly/2e8aUos JAMA
Surgery, online October 19, 2016.
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