School of Nursing and Midwifery, University of Plymouth, Devon, UK.
Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton, UK.
J Hum Nutr Diet. 2020 Jun;33(3):386-395. doi: 10.1111/jhn.12718. Epub 2019 Nov 25.
Women with obesity who become pregnant after bariatric surgery have a reduced risk of several obstetric complications; however, limited data exist from the UK population. The present study aimed to characterise a case series of women who attended a medical antenatal clinic for pregnancy following bariatric surgery.
Routine clinical information was collected retrospectively from the medical notes of women who had bariatric surgery and subsequently delivered between January 2012 and November 2018. All were seen in the medical antenatal clinic at Musgrove Park Hospital, Taunton.
Data were available for 46 pregnancies. Of these, 27.9% conceived in the first year after surgery. At 9 weeks of gestation, 13.3%, 28.9%, 33.3% and 24.4% were in the healthy, overweight, obese or severely obese category, respectively. Mean (SD) gestational weight gain was 11.9 (6.9) kg, with 54.1% gaining excess weight. Less than half (39.1%) of women were taking the recommended dose of 5 mg of folic acid when first seen. Some 56.1% and 64.6% had suboptimal iron or vitamin D statuses, respectively. Following advice from the clinic, a greater proportion of women took suitable micronutrient supplements. Subsequently, 93% of babies were born at full term, of whom 88% were of healthy weight.
Despite the nutritional risks associated with bariatric surgery and the high prevalence of obesity during pregnancy, perinatal outcomes were generally positive, with low rates of infants born preterm or low birth weight. Nutritional supplementation practices and iron status improved with input from a specialist team, underlying the importance of individualised input in this population.
接受减重手术后怀孕的肥胖女性发生多种产科并发症的风险降低；然而，英国人群的数据有限。本研究旨在对在减重手术后在医疗产前诊所就诊的怀孕女性的病例系列进行描述。
从 2012 年 1 月至 2018 年 11 月接受减重手术并随后分娩的女性的医疗记录中回顾性收集常规临床信息。所有女性均在英国塔顿的马斯格罗夫公园医院的医疗产前诊所就诊。
共 46 例妊娠的数据可用。其中，27.9%在手术后的第一年怀孕。在第 9 周，分别有 13.3%、28.9%、33.3%和 24.4%的女性处于健康、超重、肥胖或严重肥胖类别。平均（SD）妊娠期体重增加为 11.9（6.9）kg，54.1%的女性增重过多。首次就诊时，仅有 39.1%的女性服用推荐剂量的 5mg 叶酸。分别有 56.1%和 64.6%的女性铁或维生素 D 状态欠佳。根据诊所的建议，更多女性服用了合适的微量营养素补充剂。随后，93%的婴儿足月出生，其中 88%的婴儿体重健康。
尽管与减重手术相关的营养风险以及妊娠期间肥胖的高患病率，但围产期结局通常为阳性，早产儿或低出生体重儿的比例较低。在专业团队的指导下，营养补充实践和铁状态得到改善，这凸显了该人群中个体化指导的重要性。
