Retrospective Analysis of Pregnancy Following Bariatric Surgery

Background Obesity increases the risk of infertility, gestational diabetes, and hypertension. While weight loss reduces these risks, it may increase the incidence of small-for-gestational-age (SGA) infants. To investigate the effects and safety of pregnant women and neonates during pregnancy and delivery after bariatric surgery. Method A retrospective analysis was conducted on 43 women who conceived naturally after bariatric surgery at ** hospital between January 2012 and December 2021, with 24 providing complete data. The parameters included patient body mass index, postoperative pregnancy interval, maternal blood pressure and glucose levels, maternal nutritional status throughout pregnancy, mode of delivery, and neonatal outcomes such as birth weight, length, Apgar score, presence of deformities, mortality, and the need for NICU monitoring. Results Five patients underwent Roux-en-Y gastric bypass (RYGB), and 19 underwent laparoscopic sleeve gastrectomy (LSG). The average prepregnancy total weight loss (TWL) was 26.85%. During pregnancy, 45.83% of the patients developed anemia, and 16.67% of the patients experienced insufficient weight gain during pregnancy. Preoperatively, 10 of the patients had comorbid type 2 diabetes, and 8 had comorbid hypertension, which was controlled postoperatively. However, diabetes recurred in 70% of the patients during pregnancy, with the recurrence rate in the LSG group being higher than that in the RYGB group, and hypertension recurred in 50% of the patients. No neonatal deaths or NICU admissions were observed. The rate of preterm birth was 4.35%, which is below average. The incidence of smaller-for-gestational-age infants was 12.5%, occurring exclusively in pregnancies with insufficient gestational weight gain, especially after RYGB. Conclusions Pregnancy after bariatric surgery is relatively safe, reducing obesity-related complications. However, LSG may be preferable for patients with obesity who are planning pregnancy, and a waiting period is advised until their weight stabilizes. Indicators such as weight, blood pressure, blood sugar, and nutritional status should be closely monitored during pregnancy.