ESPE Abstracts

Keywords: Bariatric surgery, Pregnancy, Maternal obesity, Small for gestational age, fetal growth, Nutritional deficiencies.

Background: Maternal obesity is known to have many detrimental effects on pregnancy. Bariatric surgery represents the most efficient therapy for severe obesity. Although it is known to positively impact many pregnancy outcomes, bariatric surgery can disturb fetal growth due to nutritional deficiencies.

Objective: Our study aims to examine the repercussions of bariatric surgeries on fetal growth, and to evaluate the risk of delivering a small for gestational age (SGA) newborn while taking into consideration the type of bariatric surgery performed.

Methods: This is a single center retrospective study. Data was collected from the medical archive of Notre Dame Des Secours University Medical Center (NDS-UMC), Byblos, Lebanon between January 2013 and September 2021. In an effort to examine the effects of bariatric procedures on offspring growth, a study group(n=36) containing pregnant women who underwent bariatric surgeries, was compared with a control group of women who did not do a bariatric procedure(n=98). Then the study group was divided into purely restrictive bariatric procedures and mixed procedures.

Results: Pregnancy after bariatric surgery was associated with a reduction in mean birth weight (2885.97 versus 3244.69; P<0.001); mean birth length (48.13 versus 48.93; P<0.019), mean head circumference (33.91 versus 34.59; P=0.017) and risk of large for gestational age (0% versus 7.1%; P<0.001). However it was linked with an increased risk of small for gestational age (SGA) infants (13.9% versus 0%; P<0.001) . When comparing bariatric surgery types, a higher mean birth length was linked with purely restrictive surgeries compared with gastric bypass procedures with this association tending to significance (47.39 ± 2.03 versus 48.43 ± 1.30; P=0.052).

Conclusion: Bariatric surgery was associated with an increased risk of small for gestational age (SGA). Women of child bearing age should do a nutritional follow-up after bariatric surgery and decide carefully whether benefits outweigh adverse outcomes.