Pregnancy following gastric bypass for the treatment of morbid obesity.

Of the patients undergoing gastric bypass for treatment of morbid obesity, 75 per cent are female. A common question both pre-and postoperatively concerns the advisability of a pregnancy following surgically-induced weight loss. Of all patients, 45 became pregnant on 54 occasions following gastric bypass and 46 infants were delivered. There were two spontaneous abortions (4.0%) and six early terminations of an undesired pregnancy. Seven infants were delivered prematurely. One child was born microcephalic and has developed severe retardation in both growth and development. In contrast to reports of infants born to mothers with jejunoileal bypass, 12 of the babies that were born to mothers after gastric bypass were heavier at birth than older siblings. An additional ten infants were the first born to women who had lost more than 100 pounds following gastric bypass. All but one of the women became pregnant more than six months following surgery. This corresponds to the period of maximum weight loss and reversal of menstrual abnormalities associated with massive obesity. Pregnancies were well tolerated by the mothers, with no excessive increase in weight loss or development of metabolic deficiencies. Since the gastric bypass is modeled on the Billroth II gastrectomy, additional iron supplementation was recommended during the pregnancy. While we cannot recommend pregnancy during the period of rapid weight loss in the initial postoperative period, our data indicate that neither the mother nor the developing fetus is unduly endangered by a pregnancy which develops after the period of rapid postoperative weight loss.