Gimenes Jessica Cristina, Nicoletti Carolina Ferreira, de Souza Pinhel Marcela Augusta, de Oliveira Bruno Affonso Parenti, Salgado Júnior Wilson, Marchini Júlio Sérgio, Nonino Carla Barbosa
Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto-FMRP, Laboratory of Nutrigenomic Studies, University of São Paulo-USP, Av Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, SP, 14049-900, Brazil.
Department of Surgery and Anatomy, Faculty of Medicine of Ribeirao Preto-FMRP, University of Sao Paulo-USP, Ribeirao Preto, SP, Brazil.
Obes Surg. 2017 Jul;27(7):1815-1821. doi: 10.1007/s11695-017-2558-0.
Although pregnancy after bariatric surgery is related to risk reduction, nutritional complications may occur. This study aimed to evaluate nutritional and biochemical indicators of women who became pregnant after Roux en Y gastric bypass (RYGB).
We carried out a retrospective study with women who became pregnant after RYGB. We evaluated anthropometric, biochemical, and dietary intake indicators in the preoperative period and before, during, and after pregnancy by analysis of medical records. Shapiro-Wilk test and ANOVA for repeated measures were performed (p < 0.05).
The study included 25 patients (35.7 ± 3.8 years), who became pregnant 31.3 ± 21.7 months after RYGB. Weight loss until the beginning of pregnancy was 32.4%, and the gestational weight gain was 3.8 ± 12 kg. There was a higher frequency of patients with hypertension in the preoperative time when compared to that during the pregnancy period. Total cholesterol (180.9 ± 24.8 versus 148.5 ± 30.4 mg/dL), LDL-cholesterol (103.5 ± 19.2 versus 85.8 ± 23.1 mg/dL), HDL-cholesterol (56.4 ± 8 versus 46.9 ± 8.7 mg/dL), and latent iron-binding capacity (337.6 ± 95.8 versus 277.8 ± 65 μg/dL) were higher during the pregnancy compared to that before the pregnancy, while hemoglobin values (11.2 ± 1 versus 12.3 ± 1.2 g/dL) and sodium (138.8 ± 2.9 versus 141 ± 3 mmol/L) were lower. No differences of food intake were found among times. There is no difference on gestational weight gain between women who became pregnant before or after the first year.
During pregnancy, there was an expected weight gain and maintenance of the lipid profile within the normal range; however, there was a reduction of hemoglobin levels. These findings show the need for individualized follow-up with adequate nutritional intervention in the event of deficiencies.
尽管减肥手术后怀孕与风险降低有关，但仍可能发生营养并发症。本研究旨在评估接受Roux-en-Y胃旁路术（RYGB）后怀孕女性的营养和生化指标。
我们对接受RYGB后怀孕的女性进行了一项回顾性研究。通过分析病历，我们评估了术前以及怀孕前、中、后的人体测量、生化和饮食摄入指标。进行了Shapiro-Wilk检验和重复测量方差分析（p<0.05）。
该研究纳入了25名患者（35.7±3.8岁），她们在RYGB术后31.3±21.7个月怀孕。直至怀孕开始时体重减轻了32.4%，孕期体重增加3.8±12千克。与孕期相比，术前高血压患者的比例更高。孕期总胆固醇（180.9±24.8对148.5±30.4mg/dL）、低密度脂蛋白胆固醇（103.5±19.2对85.8±23.1mg/dL）、高密度脂蛋白胆固醇（56.4±8对46.9±8.7mg/dL）和潜在铁结合能力（337.6±95.8对277.8±65μg/dL）均高于怀孕前，而血红蛋白值（11.2±1对12.3±1.2g/dL）和钠（138.8±2.9对141±3mmol/L）则较低。各时期的食物摄入量无差异。怀孕第一年之前或之后怀孕的女性孕期体重增加无差异。
孕期体重有预期增加，血脂水平维持在正常范围内；然而，血红蛋白水平有所降低。这些发现表明，在出现营养缺乏时，需要进行个体化随访并给予适当的营养干预。
