The time from bariatric surgery-to-birth had no relevant impact on the assessed health outcomes of the children, according to researchers from the Medical University of Vienna, Vienna, Austria. They found that there were no differences noted in frequency of hospitalisation and diagnoses leading to hospitalisation in the first year of life, regardless of the surgery-to-delivery interval. The findings were featured in the paper, ‘The Timing of Pregnancies After Bariatric Surgery has No Impact on Children’s Health—a Nationwide Population-based Registry Analysis’, published in Obesity Surgery.
Although bariatric surgery has a positive impact on fertility in women, there is a lack of data regarding children’s outcomes and the ideal time for post-surgical conception. Current guidelines advise avoiding pregnancy during the initial weight loss phase (12–24 months after surgery) as there may be potential risks to offspring. Therefore, the researchers sought to analyse health outcomes in children born to mothers who had undergone bariatric surgery with a specific attention on the surgery-to-delivery interval.
For this study, the investigators examined registry data from the Austrian health insurance funds for all women who had bariatric surgery in Austria between 2010 and 2018 were analysed. A total of 1,057 women gave birth to 1,369 children. The offspring’s data were analysed for medical health claims based on International Classification of Diseases (ICD) codes and number of days hospitalised. Three different surgery-to-delivery intervals were assessed: 12, 18 and 24 months.
Gastric bypass, performed in 72% of women, was the most frequent procedure, followed by sleeve gastrectomy which was performed in 17% of cases, and gastric banding which was performed in 10%, biliopancreatic diversion was performed in less than 1% (0.5%) of all cases. A total of 63 revision operations (5%) were recorded in the databases and in 4 cases (0.3%) a further operation following the revision operation was found.
A total of 70 births (5%) were recorded up to 12 months after bariatric surgery. Moreover, 182 deliveries (13%) occurred between 12- and 18-months post-surgery and 169 births (12%) were observed between 18 and 24 months after the bariatric procedure. Furthermore, most of the deliveries (948, 69%) in this analysis were recorded at least 24 months after the bariatric procedure.
Regarding the number of days spent in hospital in the first year of life, no significant differences were observed and the frequency of hospitalization in the first year of life was comparable between the specific reference points.
Overall, two mothers died during the observation period, 8 months and 21 months after delivery and 14 months and 39 months after bariatric surgery respectively. Additionally, a child whose mother delivered 39 months after bariatric surgery died 14 months after birth due to severe comorbidities including brain malformation and hypopituitarism.
“In summary, our analysis demonstrated that approximately every third birth following bariatric surgery was observed up to 24 months post-surgery, the concluded. “Very early pregnancies up to 12 months post-surgery were also detected in our study; according to the latest guidelines these should be avoided.”
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