Ariela Goldenshluger1, Ram Elazary2, Tair Ben Porat1, Heba Geraisi Farhat2, Gabriel Levin3, Amihai Rottenstreich4. 1. Department of Nutrition, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel. 2. Department of Surgery, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel. 3. Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. 4. Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: amihai@hadassah.org.il.
Abstract
BACKGROUND: Women of childbearing age constitute a substantial proportion of the patients who undergo weight loss procedures. However, little is known regarding attitudes and behaviors of women during pregnancy after bariatric surgery (BS). OBJECTIVES: We explored women's experience and behavior during pregnancy after BS. SETTING: University hospital. METHODS: A cross-sectional survey study was performed among women who underwent sleeve gastrectomy and delivered at our center. RESULTS: Overall, 111 women completed the questionnaire (response rate 88.1%). The median surgery-to-conception interval was 34 (25-50) months. For 28 (25.2%) women, future pregnancy was a motivation for undergoing the weight loss procedure. Only 10 (9.0%) received contraceptive advice perioperatively. Oral contraception was the most commonly used method after surgery (n = 47, 42.3%). Pregnancy was reported as unintended by 37 (33.3%) women. Only 14 (12.6%) women stated receiving an explanation regarding the implications of BS on pregnancy outcomes. Rates of follow-up with maternal-fetal medicine specialists, bariatric surgeons, and dieticians during pregnancy were 36.0%, 9.0%, and 23.4%, respectively. Forty-four women (39.6%) felt follow-up throughout gestation was inadequate. Satisfaction from BS improved after pregnancy in 23 (20.7%) women, and 75 (67.6%) stated that they would recommend BS to a friend with obesity who plans to conceive in the future. CONCLUSIONS: Women reported insufficient knowledge regarding the expected outcomes of pregnancy after surgery, with low rates of medical and nutritional follow-up. Only a minority of respondents received contraceptive advice after surgery, and unintended pregnancies were common. These observations represent areas of improvement for following women of childbearing age who undergo weight loss procedures.
BACKGROUND:Women of childbearing age constitute a substantial proportion of the patients who undergo weight loss procedures. However, little is known regarding attitudes and behaviors of women during pregnancy after bariatric surgery (BS). OBJECTIVES: We explored women's experience and behavior during pregnancy after BS. SETTING: University hospital. METHODS: A cross-sectional survey study was performed among women who underwent sleeve gastrectomy and delivered at our center. RESULTS: Overall, 111 women completed the questionnaire (response rate 88.1%). The median surgery-to-conception interval was 34 (25-50) months. For 28 (25.2%) women, future pregnancy was a motivation for undergoing the weight loss procedure. Only 10 (9.0%) received contraceptive advice perioperatively. Oral contraception was the most commonly used method after surgery (n = 47, 42.3%). Pregnancy was reported as unintended by 37 (33.3%) women. Only 14 (12.6%) women stated receiving an explanation regarding the implications of BS on pregnancy outcomes. Rates of follow-up with maternal-fetal medicine specialists, bariatric surgeons, and dieticians during pregnancy were 36.0%, 9.0%, and 23.4%, respectively. Forty-four women (39.6%) felt follow-up throughout gestation was inadequate. Satisfaction from BS improved after pregnancy in 23 (20.7%) women, and 75 (67.6%) stated that they would recommend BS to a friend with obesity who plans to conceive in the future. CONCLUSIONS:Women reported insufficient knowledge regarding the expected outcomes of pregnancy after surgery, with low rates of medical and nutritional follow-up. Only a minority of respondents received contraceptive advice after surgery, and unintended pregnancies were common. These observations represent areas of improvement for following women of childbearing age who undergo weight loss procedures.
Authors: Brigid Dineley; Sarah Munro; Wendy V Norman; Boris Zevin; Dennis Hong; Babak Katiraee; Brian Fitzsimmons; Regina Renner Journal: CMAJ Open Date: 2022-03-22