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January 03, 2022

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Source / Disclosures:

Discoveries: Schoenmakers և Snoek do not report relevant financial disclosures. Please see the study for relevant financial disclosures by all other authors.


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Women undergoing bariatric surgery should wait until the weight loss stabilizes, the vitamin levels return to normal before pregnancy, according to the results of a systematic review and meta-analysis.

Women undergoing bariatric surgery’s review of 51 articles related to maternal health surgery are more likely to have increased fertility և regular menstrual cycles than those who have not had surgery, or a number of studies have found vitamin deficiencies in pregnant women. after bariatric surgery.

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“Bariatric surgery leads to an improvement in fertility without abortions, a difference in the rate of birth defects.” Katinka Snoek, MD:Candidate of Epidemiology Candidate of the Department of Obstetrics and Gynecology, Erasmus University Medical Center Sam Schonmakers, Ph.D., Ph.D.This was reported to Healio by the obstetrician-gynecologist of Erasmus University Medical Center. “It underscores the need for individualized prenatal care for women after bariatric surgery. We recommend prenatal care, including postponing pregnancy until weight loss stabilizes, regardless of surgery, from gestation to normalization of maternal vitamin status. Therefore, regular monitoring of vitamin status is recommended և vitamin supplements to correct deficiencies.

Katinka Snoek

Sam Schonmakers

The researchers searched MEDLINE, Embase, PubMed, Web of Science, Google Scholar և Cochrane databases on bariatric surgery և its effect on maternal health parameters on pericarp. Included links between endocrine changes after bariatric surgery, bariatric surgery, postoperative vitamin status, pre-conception ընթացքում during the first trimester, և prevalence of first-trimester abortion’s. A meta-analysis was performed on the results of fertility, menstrual cycle, miscarriages and birth defects.

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Several studies have found changes in the status of vitamins during pregnancy. In high-quality studies, the effect of bariatric surgery on vitamin status was inadequate. One study found that pregnant women who underwent Roux-en-Y gastric bypass had a nine-fold higher risk of developing vitamin A deficiency during pregnancy than those who did not undergo surgery. The first trimester of pregnancy after gastric bypass surgery, despite daily vitamin D supplementation. Six low-quality studies have shown that bariatric surgery is negatively associated with vitamin A, B1, B6, B12, folic acid, C, D և K levels.

“We recommend adequate, preferably adapted to the patient, to take supplements until the appropriate vitamin levels are reached, the weight stabilizes, and the patient tries to conceive,” the researchers wrote. “Bariatric surgery has been shown to be effective in weight loss, but the risks of iatrogenic malnutrition can affect fetal growth and development, the health of offspring, and the effects may not be directly visible, but are largely unknown.”

In the 20 studies that looked at the results of periconception, women who underwent bariatric surgery had a lower risk of infertility (risk difference = -0.24; 95% CI, -0.42 to -0.05) հավանական were more likely , to restore the regularity of the menstrual cycle (risk difference = -). 0.24; 95% CI, -0.34 to -0.15). Bariatric surgery is not associated with miscarriage or birth defects. The researchers found significant heterogeneity in the studied populations, showing differences in participants, interventions, and study design effects.

“Although significant weight loss has been suggested to reduce infertility, the effects of bariatric surgery on fertility have been impressive,” said Snoek և Schonmakers. “Moreover, bariatric surgery was associated with the restoration of regular menstrual cycles, which implies the return of hormonal balance.”

Schoenmakers և Snoek said the review identified the need for more long-term follow-up research during pregnancy as well as for generations. Researchers are currently conducting a long-term follow-up group of pregnant women who have undergone bariatric surgery to evaluate outcomes from the prenatal period.

“The potential side effects of over-the-counter supplements should be investigated, and individualized approaches should be a priority,” said Snoek and Schonmakers.

For more information:

Katinka Snoek, doctor, can be reached at: k.snoek@erasmusmc.nl.

Sam Schonmakers, Ph.D., Ph.D., can be reached at s.schoenmakers@erasmusmc.nl.