Bariatric surgery in women in reproductive age. Recommendation from “diabetes and pregnancy committee” and “diabetes and obesity committee” from Sociedad Argentina de Diabetes

Authors

  • Susana Gutt Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Gabriela Rovira British Hospital, Autonomous City of Buenos Aires, Argentina
  • Alicia Jawerbaum Reproduction and Metabolism Laboratory, National Council for Scientific and Technical Research (CONICET), Faculty of Medicine, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Frank Espinoza Lezica Cardiovascular Institute, Martínez, Buenos Aires Province, Argentina
  • Juliana Mociulsky Dr. Cormillot Nutrition and Health Clinic, Autonomous City of Buenos Aires, Argentina
  • Stella Maris Sucani Provincial Maternal Hospital of Córdoba Dr. Raúl Felipe Lucini, Córdoba, Argentina
  • Verónica Kojdamanian Center for Education, Prevention and Assistance to Diabetic Patients, Autonomous City of Buenos Aires, Argentina
  • Marianela Ackerman Comprehensive Center of Endocrinology and Nutrition (CIEN), Corrientes, Argentina
  • Graciela Álvarez Center for the Study and Treatment of Severe Obesity (CETOS), Autonomous City of Buenos Aires, Argentina
  • Alejandro Camaño Nutrition Service, Carlos G Durán Hospital, Autonomous City of Buenos Aires, Argentina
  • Liliana Glastein San Andrés Medical Center, Cordoba Argentina
  • Paula Lifszyc Carlos G. Durand Hospital, Autonomous City of Buenos Aires, Argentina
  • Carolina Gómez Comprehensive Center of Endocrinology and Diabetes, Concordia, Entre Ríos, Argentina
  • Patricio Mendes San Lucas Maternity; Maternity Polyclinic Neuquén, Neuquén, Argentina
  • Estrella Menéndez University Institute Center for Medical Education and Research (CEMIC), Autonomous City of Buenos Aires, Argentina
  • María Yuma Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Celina Bertona University Hospital; National University of Cuyo, Mendoza, Argentina
  • Lilia Cafaro Obesity and Mini Invasive Surgery (OCMI), Autonomous City of Buenos Aires, Argentina
  • Ícono de validado por la comunidad El Cruce Hospital, Florencio Varela, Province of Buenos Aires, Argentina
  • Susana Salzberg Centenario Institute, Autonomous City of Buenos Aires, Argentina
  • Natalia Basualdo Sardinian Maternity Hospital, Autonomous City of Buenos Aires, Argentina
  • Sandra González IMA Clinic, Autonomous City of Buenos Aires, Argentina
  • Beatriz Villarroel Dalmasio Vélez Sarsfield Acute Hospital. Santa Isabel Sanatorium, Autonomous City of Buenos Aires, Argentina
  • Carla Musso Favaloro Foundation, Autonomous City of Buenos Aires, Argentina Endocrinologist

DOI:

https://doi.org/10.47196/diab.v49i3.205

Keywords:

bariatric surgery, obesity, pregnancy, gestational diabetes

Abstract

The impact of obesity prevalence at early stages of life has been affected women at reproductive ages. Fertility rates, risk pregnancies, low weight at birth and cesarean section have been modified considerably.

Bariatric surgery is a validated tool to improved fertility but malabsortion of nutrients as a consequence of surgery could affect mother and fetus nutrition and development.

Gestacional diabetes diagnosis turns difficult in this group of obese patients after bariatric surgery.

The aim of the recommendation was to offer tools for a good control and follow up of women at reproductive age.

Author Biographies

Susana Gutt, Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Medical Specialist in Nutrition

Gabriela Rovira, British Hospital, Autonomous City of Buenos Aires, Argentina

Endocrinologist

Alicia Jawerbaum, Reproduction and Metabolism Laboratory, National Council for Scientific and Technical Research (CONICET), Faculty of Medicine, University of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Doctor from the University of Buenos Aires; Graduate in Biological Sciences

Juliana Mociulsky, Dr. Cormillot Nutrition and Health Clinic, Autonomous City of Buenos Aires, Argentina

Endocrinologist

Stella Maris Sucani, Provincial Maternal Hospital of Córdoba Dr. Raúl Felipe Lucini, Córdoba, Argentina

Physician specialist in Internal Medicine, specialist in Diabetology

Verónica Kojdamanian, Center for Education, Prevention and Assistance to Diabetic Patients, Autonomous City of Buenos Aires, Argentina

Physician specialist in Nutrition, Diabetes, Family Medicine

Marianela Ackerman, Comprehensive Center of Endocrinology and Nutrition (CIEN), Corrientes, Argentina

Medical specialist in Internal Medicine and Nutrition, Master in Diabetes

Graciela Álvarez, Center for the Study and Treatment of Severe Obesity (CETOS), Autonomous City of Buenos Aires, Argentina

Specialist in Medical Clinic and Nutrition

Alejandro Camaño, Nutrition Service, Carlos G Durán Hospital, Autonomous City of Buenos Aires, Argentina

Nutrition Service

Paula Lifszyc, Carlos G. Durand Hospital, Autonomous City of Buenos Aires, Argentina

Nutritionist

Estrella Menéndez, University Institute Center for Medical Education and Research (CEMIC), Autonomous City of Buenos Aires, Argentina

Specialist in Nutrition

María Yuma, Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina

Medical specialist in Nutrition

Celina Bertona, University Hospital; National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences; Staff Physician, University Hospital, National University of Cuyo

Lilia Cafaro, Obesity and Mini Invasive Surgery (OCMI), Autonomous City of Buenos Aires, Argentina

Nutrition Specialist Doctor

Ícono de validado por la comunidad, El Cruce Hospital, Florencio Varela, Province of Buenos Aires, Argentina

El Cruce Hospital, Florencio Varela, Province of Buenos Aires, Argentina

Susana Salzberg, Centenario Institute, Autonomous City of Buenos Aires, Argentina

Physician, specialist in Nutrition and Diabetes; Director of the Department of Clinical Research

Sandra González, IMA Clinic, Autonomous City of Buenos Aires, Argentina

Specialist doctor in Medical Clinic

Beatriz Villarroel, Dalmasio Vélez Sarsfield Acute Hospital. Santa Isabel Sanatorium, Autonomous City of Buenos Aires, Argentina

Medical specialist in Clinical Nutrition

Carla Musso, Favaloro Foundation, Autonomous City of Buenos Aires, Argentina

Endocrinologist

References

James WP. WHO recognition of the global obesity epidemic. International Journal of Obesity (2005) 2008, 32 Suppl 7, S120-126.

Sirimi N, Goulis DG. Obesity in pregnancy. Hormones 2010, 9, 299-306.

Mitchell S, Shaw D. The worldwide epidemic of female obesity. Best practice & research. Clinical Obstetrics & Gynaecology 2015, 29, 289-299.

Racusin D, Stevens B, Campbell G, Aagaard KM. Obesity and the risk and detection of fetal malformations. Seminars in perinatology 2012, 36, 213-221.

Encuesta Nacional de Factores de Riesgo, ENFR 2013. Ministerio de Salud de la Nación.

Weiss JL, Malone FD, Emig D, Ball RH, et al. Obesity, obstetric complications and cesarean delivery rate. A population-based screening study. Am. J. Obstet. Gynecol. 2004, 190, 1091-1097.

Morgan ES, Wilson E, Watkins T, Gao F, Hunt B J. Maternal obesity and venous thromboembolism. International Journal of Obstetric Anesthesia 2012, 21, 253-263.

Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. N. Engl. J. Med. 2008, 359, 2025-2033.

Catalano PM. Management of obesity in pregnancy. Obstet. Gynecol. 2007, 109, 419-433.

Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet. Gynecol. 2004, 103, 219-224.

Álvarez MGR, y col. Revista de la Sociedad Argentina de Diabetes 2013; 47:69-80.

American College of Obstetritian and Gynecologist, ACOG. Practice Bulletin Nº 105: Bariatric surgery and pregnancy. Obstet. Gynecol. 2009,113:1405-1413.

Magdaleno RJr, Pereira BG, Chaim EA, Turato ER. Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges. Arch. Gynecol. Obstet. 2012 Mar; 285(3):559-66.

Beard J, et al. Reproductive considerations and pregnancy after bariatric surgery: current evidence and recommendations. Obes. Surg. 2008: 18 1023-1027.

Consenso Argentino de Nutrición en Cirugía Bariátrica. Actualización en Nutrición. 2011, Junio. Vol. 12. Nº 2.

Kominiarek MA. Semin. Perinatol. 2011; 35(6): 356-361.

Patel JA, Patel NA, Thomas RL, Nelms JK, Colella JJ. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg. Obes. Relat. Dis. 2008 Jan/feb;4(1):39-45.

Printin K J, Scott D. Pregnancy following gastric bypass for the treatment of morbid obesity. American Journal of Surgery, 1982, 4 8: 363-365.

Weiss HG, Nehoda H, Labeck B, Hourmont K, Marth C, Aigner F. Pregnancies after adjustable gastric banding. Obesity Surgery, 2001, 11:303-306.

Willis K, Lieberman N, Sheiner E, et al. Pregnancy and neonatal outcome after bariatric surgery. Best Practice & Research Clinical Obstetrics and Gynaecology 2015 (29): 133-144.

Sheiner E, Edri A, Balaban E, et al. Pregnancy outcome of patients who conceive during or after the first year following bariatric surgery. Am. J. Obstet. Gynecol. 2011; 240:50e1-6.

Wax JR, Cartin A, Wolff R, Lepich S, Pinette MG, Blackstone J. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes. Surg. 2008; 18(12):1517.

Haward RN, Brown WA. Does pregnancy increase the need for revisional surgery afterlaparoscopic adjustable gastric banding? Obes. Surg. Aug 1.2010 published online.

Lapolla A, Marangon M, Dalfra MG, et al. Pregnancy outcome in morbidly obese women before and after laparoscopic gastric banding. Obes. Surg. 2010; 20:1251-1257.

Johansson K, Cnattingius S, Näslund I, et al. Outcomes of pregnancy after bariatric surgery. N. Engl. J. Med. 2015; 372: (9) 814-824.

Wax JR, Cartin A, Wolff R, et al. Pregnancy following gastric bypass surgery for morbid obesity: effect of surgery to conception interval on maternal and neonatal outcomes. Obes. Surg. 2008;18:540-544.

Lesk J; Peaceman A. Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls. Obstetrics & Gynecology. March 2012- Vol. 119- Issue 3- p 547-554.

Bebber FE, Rizzolli J, Casagrande DS, et al. Pregnancy after bariatric surgery: 39 pregnancies follow-up in a multidisciplinary team. Obes. Surg. 2010 Sep 05.

Woodard CB. Pregnancy following bariatric surgery. Journal of Perinatal and Neonatal Nursing, Vol. 18, Nº 4, pp. 329-340, 2004.

Stephansson K, et al. Outcomes of pregnancy after bariatric suregry. N. Engl. J. Med. 372:9 pp. 814-824, 2015.

Kaska L, Kobiela J, Abacjew-Chmylko A, et al. Nutrition and pregnancy after bariatric surgery. ISRN Obesity. Vol 2013, article ID 492060, 6 pages. Review http://www.hindawi.com/journals/isrn/2013/492060/ ultima vez visto 21/6/2015.

Uzoma A, Keriakos R. Pregnancy management following bariatric surgery. Journal of Obstetrics and Gynaecology, February 2013; 33: 109-114. Review.

Decker GA, Swain JM, Crowell MD, Scolapio JS. Gastrointestinal and nutritional complications after bariatric surgery. American Journal of Gastroenterology, Vol. 102, Nº 11, pp. 2571-2580, 2007.

Nomura RM, Dias MC, Igai AM, Paiva LV, Zugaib M. Anemia during pregnancy after silastic ring Roux-en-Y gastric bypass: influence of time to conception. Obes. Surg. 2011;21:479-484.

Smith J, Cianflone K, Biron S, et al. Effects of maternal surgical weight loss in mothers on intergenerationl transmission of obesity. J. Clin. Endocrinol. Metab. 2009;94:4275-83.

Guenard F, Patty ME. Reducing maternal weight improves offspring metabolism and alters(or modulates) methylation. PNAS 2013, 110: 32, 12859-12860.

Kral JG, et al. Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years. Pediatrics 118:e1644–e1649. 2006.

Gadgil M, et al Laboratory testing for and diagnosis of nutritional deficiencies in pregnancy regnancy before and after bariatric surgery. J. Womens Health (Larchmt). 2014 Feb 1; 23(2): 129-137.

Burke AE, Bennett WL, Jamshidi RM, et al. Reduced incidence of gestational diabetes with bariatric surgery. J. Am. Coll. Surg. 2010;211:169-75.

Kominiarek MA. Preparing for and managing a pregnancy after bariatric surgery. Semin Perinatol. 2011 December ; 35(6): 356-361.

Scheiner E, et al. Pregnancy outcome of patients with gestational diabetes mellitus following bariatric surgery. American Journal of Obstetrics and Gynecology (2006) 194, 431-5.

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292:1724-37.

Wax JR, Pinette MG, Cartin A, Blackstone J. Female reproductive issues following bariatric surger. Obstet. Gynecol. Surv. 2007; 62:595.

American Diabetes Association. Gestational diabetes mellitus. Practice Guideline. Diabetes Care 2004; 27: 88-90.

Roslin MS, Oren JH, Polan BN, Damani T, Brauner R, Shah PC. Abnormal glucose tolerance testing after gastric bypass. Surg. Obes. Relat. Dis 2013; 9:26.

Recomendaciones para la gestante con diabetes. Revista de la Sociedad Argentina de Diabetes. Vol. 43, Nº 2:73-81, 2009.

Freitas C. Effect of new criteria on the diagnosis of gestational diabetes in women submitted to gastric bypass surgery for obesity and related diseases 2014, 10 (6): 1041-1046.

Guelinckx I. Reproductive outcome after bariatric surgery: a critical review (Review). Human Reproduction Update, Vol. 15, Issue 2, 2009, pages 189-201.

Apovian CM, Cummings S, Anderson W, et al. Best practice updates for multidisciplinary care in weight loss surgery. Obesity (Silver Spring) 2009; 17:871.

NICE Guideline. Published: 25 February 2015nice.org.uk/guidance/ng3.

Grahan Y, Wilkes S, Mansour D, Small PK. Contraceptivo needs of women following bariatric surgery. Fam. Plann Reprod. Health Care 2014 40:241-244.

Paulen ME, Zapata LB, Cansino C, et al. Contraceptive use among women with a history of bariatric surgery: a systematic review. Contraception 2010; 82:86.

Hilman JB, Miller RJ, Inge TH. Menstrual concerns and intrauterine contraception among adolescent bariatric surgery patients. Journal of Women´s Health Vol. 20 Nº 4 2011.

Ciangura C, Corigliano N, Basdevant A, et al. Etonogestrel concentration in morbidly obese woman following Roux-en- Y gastric bypass surgery: three case reports.

Zaher O, Merhi MD. Challenging oral contraception after weight loss by bariatric surgery. Gynecol. Obstret. Invest. 2007; 64:100-102.

Zaher O, Merhi MD. Revisiting optimal hormonal contraception following bariatric surgery.Contraception 87 (2013) 131-133.

Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr59e0528a1.htm (Accessed on May 28, 2010).

Downloads

Published

2023-01-10

How to Cite

Gutt, S., Rovira, G., Jawerbaum, A., Espinoza, F., Mociulsky, J., Sucani, S. M., Kojdamanian, V., Ackerman, M., Álvarez, G., Camaño, A., Glastein, L., Lifszyc, P., Gómez, C., Mendes, P., Menéndez, E., Yuma, M., Bertona, C., Cafaro, L., Fuentes, S., Salzberg, S., Basualdo, N., González, S., Villarroel, B., & Musso, C. (2023). Bariatric surgery in women in reproductive age. Recommendation from “diabetes and pregnancy committee” and “diabetes and obesity committee” from Sociedad Argentina de Diabetes. Journal of the Argentine Society of Diabetes, 49(3), 85–94. https://doi.org/10.47196/diab.v49i3.205

Issue

Vol. 49 No. 3 (2015): September/December 2015

Section

Recommendations

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.

La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.

Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.