When a woman in the child bearing years undergoes gastric bypass surgery to lose weight one of the first things she will hear from the nay-sayers is that after surgery she cannot have a healthy pregnancy because of presumed nutritional deficiencies. The contrary is true. Morbid obesity results in a high rate of complicated pregnancies and a high rate of miscarriage. Women who become pregnant after achieving weight loss with gastric bypass generally have lower risk pregnancies than morbidly obese women. The United States Surgeon General lists several reproductive complications associated with pregnancy in women who are obese. Complications include an increased risk of death in both the baby and the mother and increases the risk of maternal high blood pressure by 10 times. In addition to many other complications, women who are obese during pregnancy are more likely to have gestational diabetes and problems with labor and delivery. The Surgeon General concludes that Infants born to women who are obese during pregnancy are more likely to be high birth weight and, therefore, may face a higher rate of Cesarean section delivery and low blood sugar (which can be associated with brain damage and seizures). Obesity during pregnancy is associated with an increased risk of birth defects, particularly neural tube defects, such as spina bifida. In a study by Dr. Alan C. Wittgrove, past president of the American Society of Bariatric Surgery and pioneer of the laparoscopic technique, post-gastric bypass pregnancy indicates fewer risks than commonly reported by women who are obese during pregnancy. His study was conducted with nurse-practitioner Leslie Jester who had a low-risk pregnancy and delivered a healthy baby after gastric bypass surgery. The Wittgrove Center has an active patient list of over 2000 people. The patients are informed to contact the Center when they become pregnant. In the study 41 women in the patient population became pregnant. Using personal interview, questionnaire, and review of perinatal records, pregnancy-related risks and complications were studied. The study found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesity. There were no patients with clinically significant anemia. Dr. Wittgrove concluded, Since the patients had an operation that restricts their food intake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies. The post-surgical group had fewer pregnancy-related complications than did an internally controlled group that were morbidly obese during their previous pregnancies. |
