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Journal of Obesity
Volume 2018, Article ID 4587064, 14 pages
https://doi.org/10.1155/2018/4587064
Review Article

Management of Pregnant Women after Bariatric Surgery

1Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, Austria
2Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, Austria
3Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
4Department of Surgery, Medical University Vienna, Vienna, Austria
5Medizinische Abteilung mit Endokrinologie, Diabetologie, Nephrologie, Krankenanstalt Rudolfstiftung, Vienna, Austria

Correspondence should be addressed to Alexandra Kautzky-Willer; ta.ca.neiwinudem@relliw-ykztuak.ardnaxela

Received 22 November 2017; Accepted 29 April 2018; Published 3 June 2018

Academic Editor: Till Hasenberg

Copyright © 2018 Jürgen Harreiter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can resolve hormonal imbalance. So far, guidelines suggest conceiving after losing maximum weight and thus recommend conception at least 12–24 months after surgery. As limited data of these suggestions exist, further evidence is urgently needed as well for weight gain in pregnancy. Oral glucose tolerance tests for the diagnosis of gestational diabetes mellitus (GDM) should not be performed after bariatric procedures due to potential hypoglycaemic adverse events and high variability of glucose levels after glucose load. This challenges the utility of the usual diagnostic criteria for GDM in accurate prediction of complications. Furthermore, recommendations on essential nutrient supplementation in pregnancy and lactation in women after bariatric surgery are scarce. In addition, nutritional deficiencies or daily intake recommendations in pregnant women after bariatric surgery are not well investigated. This review summarizes current evidence, proposes clinical recommendations in pregnant women after bariatric surgery, and highlights areas of lack of evidence and the resulting urgent need for more clinical investigations.