Bariatric (weight-loss) surgery was found to substantially reduce the risk of several pregnancy-related complications and poor outcomes in a new study, published in the American Journal of Obstetrics and Gynecology.
Bariatric surgery can take a number of different forms, including gastric bypass and gastric banding. Gastric bypass, in particular, has been shown to be an effective treatment for type 2 diabetes in people who qualify for the surgery based on their body weight — often leading to major improvements in blood glucose control or even complete remission of type 2 diabetes. While some studies on bariatric surgery in diabetes have included mostly older adults past the age of childbearing, there are many younger adults with obesity — some of whom have type 2 diabetes — who stand to benefit from any beneficial pregnancy-related outcomes that the surgery might provide.
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For the latest study, researchers at a large health system in Southern California looked at data from 20,213 women who gave birth and were eligible for bariatric surgery based on their body weight and health status. Among those who were eligible for the surgery, though, only 1,886 (9.3%) actually had the surgery prior to their pregnancy. The researchers compared pregnancy-related outcomes between the women who had bariatric surgery and those who didn’t.
Bariatric surgery linked to lower preeclampsia risk, other improved outcomes
As described in a press release on the study, bariatric surgery was linked to a number of improved outcomes, including a 47% lower risk for preeclampsia — a pregnancy complication that can cause suddenly high blood pressure and organ damage. Women who had bariatric surgery were also 40% less likely to develop gestational diabetes during pregnancy, and 35% less likely to require a cesarean section (C-section) to give birth. Other benefits included a 76% lower risk for macrosomia (when a baby is much larger than average at birth) and a 55% lower risk for chorioamnionitis (infection of fluid and membranes in the uterus).
There were also some increased health risks linked to bariatric surgery. Women who had the surgery were 146% more likely to give birth to a baby that was small for its gestational age, and were 79% more likely to experience hemorrhage (blood loss) after giving birth. The researchers noted that these risks weren’t linked to the amount of time between bariatric surgery and giving birth, so it’s unlikely that they’re related to an ongoing recovery from the surgery.
“These data suggest that there are many pregnancy outcome benefits for women with severe obesity who undergo bariatric surgery,” the researchers concluded. “However, women who have undergone bariatric surgery before pregnancy should be monitored closely to reduce the risk for small-for-gestational-age neonates and postpartum hemorrhage.
Want to learn more about bariatric surgery and type 2 diabetes? Read “Is Bariatric Surgery for You?” and “Bariatric Surgery and Diabetes: Questions and Answers.”
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