Gestational weight gain and postpartum weight retention after bariatric surgery: data from a prospective cohort study

被引：13

作者：

Ceulemans, Dries ^{[1
,2
]}

De Mulder, Paulien ^{[3
]}

Lebbe, Barbara ^{[4
]}

Coppens, Marc ^{[5
]}

Becker, Ben De ^{[6
]}

Dillemans, Bruno ^{[7
]}

Saey, Jean-Paul ^{[8
]}

Lemmens, Luc ^{[9
]}

Logghe, Hilde ^{[10
]}

Loccufier, Ann ^{[4
]}

Van der Schueren, Bart ^{[11
,12
]}

Mertens, Ann ^{[11
,12
]}

Matthys, Christophe ^{[11
,12
]}

Deleus, Ellen ^{[11
,13
]}

Verhaeghe, Johan ^{[1
,2
]}

Lannoo, Lore ^{[1
,2
]}

Lannoo, Matthias ^{[11
,13
]}

Godderis, Lode ^{[14
,15
]}

Roelens, Kristien ^{[3
]}

Ameye, Lieveke ^{[1
]}

Bogaerts, Annick ^{[1
,16
]}

Devlieger, Roland ^{[1
,2
,6
]}

机构：

[1] Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium

[2] Univ Hosp Leuven, Dept Obstet & Gynaecol, Herestr 49, B-3000 Leuven, Belgium

[3] Ghent Univ Hosp, Dept Obstet & Gynaecol, Ghent, Belgium

[4] Acad Hosp St Jan, Dept Obstet & Gynaecol, Brugge, Belgium

[5] ZNA Middelheim, Dept Obstet & Gynecol, Antwerp, Belgium

[6] St Augustinus Hosp, Dept Obstet Gynecol & Reprod, Antwerp, Belgium

[7] St Jan Hosp, Dept Abdominal Surg, Brugge, Belgium

[8] CHR, Medicosurg Unit Metab Dis, Mons, Belgium

[9] St Nikolaas Hosp, Dept Abdominal Surg, St Niklaas, Belgium

[10] St Lucas Hosp, Dept Obstet & Gynecol, Brugge, Belgium

[11] Katholieke Univ Leuven, Clin & Expt Endocrinol, Dept Chron Dis & Metab, Leuven, Belgium

[12] Univ Hosp Leuven, Dept Endocrinol, Leuven, Belgium

[13] Univ Hosp Leuven, Dept Abdominal Surg, Leuven, Belgium

[14] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Ctr Environm & Hlth, Leuven, Belgium

[15] Idewe, External Serv Prevent & Protect Work, Heverlee, Belgium

[16] Univ Antwerp, Fac Med & Hlth Sci, Ctr Res & Innovat Care CRIC, Antwerp, Belgium

来源：

SURGERY FOR OBESITY AND RELATED DISEASES | 2021年 / 17卷 / 04期

关键词：

IUGR; Gastric bypass; Sleeve gastrectomy; Gastric banding; BPD; Billiopancreatic diversion; GASTRIC BYPASS; PERINATAL OUTCOMES; PREGNANCY; WOMEN; INTERVENTION;

D O I：

10.1016/j.soard.2020.12.009

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: It is unknown whether international guidelines on gestational weight gain can be used in pregnancies after bariatric surgery. Objectives: To investigate gestational weight gain, intrauterine growth, and postpartum weight retention in postbariatric women. Setting: 8 Belgian hospitals. Methods: Prospective data from 127 postbariatric pregnancies from September 2014 through October 2018. Patients were grouped according to achievement of 2009 Institute of Medicine (IOM) guidelines. Results: In 127 patients with a mean age of 30.2 years (standard deviation [SD], 4.7), the mean gestational weight gain was 12.5 kg (SD, 6.7). Of these patients, 24% (30 of 127) showed insufficient weight gain, 20% (26 of 127) showed adequate weight gain, and 56% (71 of 127) showed excessive weight gain. Of 127 patients, 27 (21%) had small-for-gestational-age infants. This peaked in the group with insufficient weight gain (47%; 95% confidence interval [CI], 29%-65%; P < .001). The prevalence of large-for-gestational-age infants was comparable between groups, although highest in the group with excessive weight gain (0% in those with insufficient weight gain, 4% in those with adequate weight gain, and 8% in those with excessive weight gain). Preterm births were recorded more in patients with insufficient weight gain (23%; 95% CI, 8%-38%; P = .048). The mean amounts of postpartum weight retained were 4.0 kg (SD, 7.4) at 6 weeks and 3.0 kg (SD, 9.1) at 6 months. Weight retention at 6 weeks (7.1 kg; 95% CI, 5.5-8.7; P < .001) and 6 months (8.3 kg; 95% CI, 4.5-12.2; P < .001) was highest in women gaining excessive weight. Conclusion: Achievement of IOM guidelines is low in postbariatric pregnancies. Insufficient weight gain increases the risk for small-for-gestational-age babies. Excessive weight gain increases weight retention after delivery and could precipitate weight regain. After bariatric surgery, women should be encouraged to achieve IOM recommendations. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

引用

页码：659 / 666

页数：8

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