Management of Pregnant Women after Bariatric Surgery
The prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can...
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doaj-71df1ac344ad4feb96f788dc48c6a6882020-11-24T21:07:29ZengHindawi LimitedJournal of Obesity2090-07082090-07162018-01-01201810.1155/2018/45870644587064Management of Pregnant Women after Bariatric SurgeryJürgen Harreiter0Karin Schindler1Dagmar Bancher-Todesca2Christian Göbl3Felix Langer4Gerhard Prager5Alois Gessl6Michael Leutner7Bernhard Ludvik8Anton Luger9Alexandra Kautzky-Willer10Michael Krebs11Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, AustriaDivision of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, AustriaDepartment of Surgery, Medical University Vienna, Vienna, AustriaDepartment of Surgery, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaGender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaDivision of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, AustriaThe prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can resolve hormonal imbalance. So far, guidelines suggest conceiving after losing maximum weight and thus recommend conception at least 12–24 months after surgery. As limited data of these suggestions exist, further evidence is urgently needed as well for weight gain in pregnancy. Oral glucose tolerance tests for the diagnosis of gestational diabetes mellitus (GDM) should not be performed after bariatric procedures due to potential hypoglycaemic adverse events and high variability of glucose levels after glucose load. This challenges the utility of the usual diagnostic criteria for GDM in accurate prediction of complications. Furthermore, recommendations on essential nutrient supplementation in pregnancy and lactation in women after bariatric surgery are scarce. In addition, nutritional deficiencies or daily intake recommendations in pregnant women after bariatric surgery are not well investigated. This review summarizes current evidence, proposes clinical recommendations in pregnant women after bariatric surgery, and highlights areas of lack of evidence and the resulting urgent need for more clinical investigations.http://dx.doi.org/10.1155/2018/4587064 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jürgen Harreiter Karin Schindler Dagmar Bancher-Todesca Christian Göbl Felix Langer Gerhard Prager Alois Gessl Michael Leutner Bernhard Ludvik Anton Luger Alexandra Kautzky-Willer Michael Krebs |
spellingShingle |
Jürgen Harreiter Karin Schindler Dagmar Bancher-Todesca Christian Göbl Felix Langer Gerhard Prager Alois Gessl Michael Leutner Bernhard Ludvik Anton Luger Alexandra Kautzky-Willer Michael Krebs Management of Pregnant Women after Bariatric Surgery Journal of Obesity |
author_facet |
Jürgen Harreiter Karin Schindler Dagmar Bancher-Todesca Christian Göbl Felix Langer Gerhard Prager Alois Gessl Michael Leutner Bernhard Ludvik Anton Luger Alexandra Kautzky-Willer Michael Krebs |
author_sort |
Jürgen Harreiter |
title |
Management of Pregnant Women after Bariatric Surgery |
title_short |
Management of Pregnant Women after Bariatric Surgery |
title_full |
Management of Pregnant Women after Bariatric Surgery |
title_fullStr |
Management of Pregnant Women after Bariatric Surgery |
title_full_unstemmed |
Management of Pregnant Women after Bariatric Surgery |
title_sort |
management of pregnant women after bariatric surgery |
publisher |
Hindawi Limited |
series |
Journal of Obesity |
issn |
2090-0708 2090-0716 |
publishDate |
2018-01-01 |
description |
The prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can resolve hormonal imbalance. So far, guidelines suggest conceiving after losing maximum weight and thus recommend conception at least 12–24 months after surgery. As limited data of these suggestions exist, further evidence is urgently needed as well for weight gain in pregnancy. Oral glucose tolerance tests for the diagnosis of gestational diabetes mellitus (GDM) should not be performed after bariatric procedures due to potential hypoglycaemic adverse events and high variability of glucose levels after glucose load. This challenges the utility of the usual diagnostic criteria for GDM in accurate prediction of complications. Furthermore, recommendations on essential nutrient supplementation in pregnancy and lactation in women after bariatric surgery are scarce. In addition, nutritional deficiencies or daily intake recommendations in pregnant women after bariatric surgery are not well investigated. This review summarizes current evidence, proposes clinical recommendations in pregnant women after bariatric surgery, and highlights areas of lack of evidence and the resulting urgent need for more clinical investigations. |
url |
http://dx.doi.org/10.1155/2018/4587064 |
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