Huluță Iulia, Apostol Livia-Mihaela, Botezatu Radu, Panaitescu Anca Maria, Gică Corina, Sima Romina-Marina, Gică Nicolae, Nedelea Florina Mihaela
Clinical Hospital of Obstetrics and Gynaecology Filantropia, 011132 Bucharest, Romania.
Obstetrics and Gynecology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Medicina (Kaunas). 2024 Apr 15;60(4):635. doi: 10.3390/medicina60040635.
The increasing prevalence of bariatric surgery among women of childbearing age raises critical questions about the correct management of pregnancy following these procedures. This literature review delves into the multifaceted considerations surrounding pregnancy after bariatric surgery, with a particular focus on the importance of preconception counselling, appropriate nutrition assessment, and the necessity of correct folic acid supplementation. Key areas of investigation include nutrient absorption challenges, weight gain during pregnancy, and potential micronutrient deficiencies. Examining the relationship between bariatric surgery and birth defects, particularly heart and musculoskeletal issues, uncovers a twofold increase in risk for women who underwent surgery before pregnancy, with the risk emphasized before folic acid fortification. In contrast, a nationwide study suggests that infants born to mothers with bariatric surgery exhibit a reduced risk of major birth defects, potentially associated with improved glucose metabolism. In addition, this review outlines strategies for managing gestational diabetes and other pregnancy-related complications in individuals with a history of bariatric surgery. By synthesizing existing literature, this paper aims to provide healthcare providers with a comprehensive framework for the correct management of pregnancy in this unique patient population, promoting the health and well-being of both mother and child.
减肥手术在育龄妇女中的日益普及引发了关于这些手术后正确管理妊娠的关键问题。这篇文献综述深入探讨了减肥手术后妊娠的多方面考量,特别关注孕前咨询的重要性、适当的营养评估以及正确补充叶酸的必要性。主要研究领域包括营养吸收挑战、孕期体重增加以及潜在的微量营养素缺乏。研究减肥手术与出生缺陷之间的关系,尤其是心脏和肌肉骨骼问题,发现孕前接受手术的女性风险增加了两倍,且在叶酸强化之前风险更为突出。相比之下,一项全国性研究表明,接受减肥手术的母亲所生婴儿出现重大出生缺陷的风险降低,这可能与改善的葡萄糖代谢有关。此外,本综述概述了管理有减肥手术史个体的妊娠期糖尿病和其他妊娠相关并发症的策略。通过综合现有文献,本文旨在为医疗保健提供者提供一个全面的框架,以便在这一独特患者群体中正确管理妊娠,促进母婴的健康和福祉。