Maternal nutritional status and related pregnancy outcomes following bariatric surgery: A systematic review.
Study Goal
The researchers aimed to evaluate the association between maternal nutritional status (including calcium) and maternal/perinatal outcomes in postbariatric surgery pregnancies.
Results Summary
The study found calcium deficiencies among pregnant postbariatric surgery patients, but no adverse events specifically linked to calcium deficiency were documented. Evidence of calcium deficiency affecting pregnancy outcomes was lacking.
Population
Women of childbearing age who underwent bariatric surgery and subsequently became pregnant.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
bariatric surgery | increase | fertility | women with obesity | - | improved | #1 |
maternal nutritional status | no change | maternal and perinatal outcomes | pregnant postbariatric surgery patients | - | is not well established | #2 |
- | decrease | maternal concentrations of vitamins A, B1, B6, B12, C, D, K, iron, calcium, selenium, and phosphorous | women with pregnancies after bariatric surgery | - | deficiencies were reported | #3 |
vitamin B12 deficiency | increase | anemia | pregnant postbariatric surgery patients | - | adverse events documented | #4 |
iron deficiency | increase | anemia | pregnant postbariatric surgery patients | - | adverse events documented | #5 |
vitamin A deficiency | increase | night blindness | pregnant postbariatric surgery patients | - | adverse events documented | #6 |
vitamin A deficiency | increase | urinary tract infections | pregnant postbariatric surgery patients | - | adverse events documented | #7 |
vitamin D deficiency | increase | urinary tract infections | pregnant postbariatric surgery patients | - | adverse events documented | #8 |
micronutrient deficiencies | increase | - | pregnant postbariatric surgery patients | - | are common | #9 |
micronutrient deficiencies | no change | adversely affect pregnancy outcomes (e.g., lower neonatal birth weight) | pregnant postbariatric surgery patients | - | evidence of such is lacking | #10 |
Up to 80% of patients who undergo bariatric surgery are women of childbearing age. Coupled with improved fertility in women with obesity after bariatric surgery, pregnancy postbariatric surgery has become increasingly more common. Although numerous studies have evaluated associations of bariatric surgery with pregnancy outcomes, the effect of maternal nutritional status on maternal and perinatal outcomes is not well established. We used Medline and Embase databases and a manual search of references for articles published until June 2018 to conduct a systematic review on nutritional status after bariatric surgery and its association with maternal and perinatal outcomes. Of the 306 initially identified articles, 27 met the study inclusion criteria, comprising 2056 women with pregnancies after bariatric surgery. Deficiencies were reported in maternal concentrations of vitamins A, B1, B6, B12, C, D, K, iron, calcium, selenium, and phosphorous. The only adverse events documented for these deficiencies encountered during pregnancy were anemia (vitamin B12, iron), night blindness (vitamin A), and urinary tract infections (vitamin A, D). This systematic review suggests that various micronutrient deficiencies are common among pregnant postbariatric surgery patients. Nevertheless, despite the concern that these deficiencies could adversely affect pregnancy outcomes (e.g., lower neonatal birth weight), evidence of such is lacking. Further prospective studies are warranted to confirm our findings and better delineate the optimal supplementation regimen during pregnancy after bariatric surgery.