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Bariatric Surgery Can Complicate Subsequent Pregnancies. Does Your Doctor Know Best?

Most of us know about the benefits of bariatric surgery, most notably losing weight. But a new study finds that a large proportion of doctors don’t take action to prevent a known problem: complications during subsequent pregnancies.

In response to the obesity epidemic, many American have turned to bariatric surgery to reduce the size of the stomach and promote weight loss. The majority of bariatric patients are reproductive age women.

In addition to losing about 60 percent of their additional weight, bariatric patients experience improvements in weight-related health concerns, like diabetes, high blood pressure, and sleep apnea. Women also benefit from reduced risk of high blood pressure and diabetes during pregnancy. Despite these health benefits, there are drawbacks. Following surgery, women experience an increased risk of small for gestational age infants.

The American College of Obstetricians and Gynecologists published a series of guidelines to help practitioners care for pregnant women who had undergone bariatric surgery. Marcela C. Smid, MD, assistant professor Department of Obstetrics and Gynecology at the University of Utah Health, conducted a nationwide survey to assess obstetricians’ knowledge of these guidelines when caring for pregnant women after bariatic surgery. The results are published online in March issue of Obesity Surgery.

The results suggest that a gap exists between best practice guidelines and obstetrician knowledge and recommendations for these patients. One-third of the responding obstetricians rarely or never recommended an extra multivitamin for women who had bariatric surgery, while only one-third of the obstetricians correctly identified potentially dangerous gastrointestinal complications in these women during pregnancy.

The authors suggest renewed efforts to target obstetricians to improve their knowledge about the guidelines to improve care for pregnant women following bariatric surgery.

Marcela Smidobstetrics, gynecology