Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care

被引:146
作者
Shawe, Jill [1 ]
Ceulemans, Dries [2 ,3 ]
Akhter, Zainab [4 ]
Neff, Karl [5 ]
Hart, Kathryn [6 ]
Heslehurst, Nicola [4 ]
Stotl, Iztok [7 ]
Agrawal, Sanjay [8 ]
Steegers-Theunissen, Regine [9 ]
Taheri, Shahrad [10 ]
Greenslade, Beth [11 ]
Rankin, Judith [4 ]
Huda, Bobby [12 ,13 ]
Douek, Isy [11 ]
Galjaard, Sander [9 ]
Blumenfeld, Orit [14 ]
Robinson, Ann [15 ]
Whyte, Martin [16 ]
Mathews, Elaine [17 ]
Devlieger, Roland [2 ,3 ,18 ]
机构
[1] Univ Plymouth, Fac Hlth & Human Sci, Plymouth, Devon, England
[2] Katholieke Univ Leuven, Dept Dev & Regenerat, Leuven, Belgium
[3] Univ Hosp Leuven, Dept Obstet & Gynaecol, Herestr 49, B-3000 Leuven, Belgium
[4] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne, Tyne & Wear, England
[5] Kings Coll Hosp NHS Fdn Trust, London, England
[6] Univ Surrey, Fac Hlth & Med, Dept Nutr Sci, Guildford, Surrey, England
[7] Univ Med Ctr, Dept Endocrinol Diabet & Metab Dis, Ljubljana, Slovenia
[8] Homerton Univ Hosp, Dept Upper Gastrointestinal & Bariatr Surg, London, England
[9] Erasmus MC, Dept Obstet & Gynaecol, Div Obstet & Prenatal Med, Rotterdam, Netherlands
[10] Qatar Fdn, Weill Cornell Med Qatar, Doha, Qatar
[11] Musgrove Pk Hosp, Taunton, Somerset, England
[12] St Bartholomews Hosp, Dept Diabet & Metab, London, England
[13] Barts Hlth NHS Trust, Royal London Hosp, London, England
[14] Minist Hlth, Israel Ctr Dis Control, Jerusalem, Israel
[15] Univ Surrey, Fac Hlth & Med Sci, Guildford, Surrey, England
[16] Univ Surrey, Dept Clin & Expt Med, Guildford, Surrey, England
[17] Western Sussex NHS Fdn Trust, St Richards Hosp Bariatr Surg Serv, Chichester, England
[18] St Augustinus Hosp Wilrijk, Dept Obstet Gynaecol & Reprod, Antwerp, Belgium
基金
美国国家卫生研究院;
关键词
bariatric surgery; metabolic surgery; obesity; pregnancy; obstetrics; gynaecology; Y GASTRIC BYPASS; GESTATIONAL WEIGHT-GAIN; VITAMIN-A-DEFICIENCY; NEONATAL OUTCOMES; CONTRACEPTIVE NEEDS; NUTRITIONAL INDEXES; CONCEPTION INTERVAL; PROCEDURE SELECTION; SLEEVE GASTRECTOMY; TO-CONCEPTION;
D O I
10.1111/obr.12927
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The objective of the study is to provide evidence-based guidance on nutritional management and optimal care for pregnancy after bariatric surgery. A consensus meeting of international and multidisciplinary experts was held to identify relevant research questions in relation to pregnancy after bariatric surgery. A systematic search of available literature was performed, and the ADAPTE protocol for guideline development followed. All available evidence was graded and further discussed during group meetings to formulate recommendations. Where evidence of sufficient quality was lacking, the group made consensus recommendations based on expert clinical experience. The main outcome measures are timing of pregnancy, contraceptive choice, nutritional advice and supplementation, clinical follow-up of pregnancy, and breastfeeding. We provide recommendations for periconception, antenatal, and postnatal care for women following surgery. These recommendations are summarized in a table and print-friendly format. Women of reproductive age with a history of bariatric surgery should receive specialized care regarding their reproductive health. Many recommendations are not supported by high-quality evidence and warrant further research. These areas are highlighted in the paper.
引用
收藏
页码:1507 / 1522
页数:16
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