Morgan Harriet D, Morrison Amy E, Hamza Malak, Jones Cathy, Cassar Caroline Borg, Meek Claire L
Diabetes Research Centre, Leicester NIHR Biomedical Research Centre, Leicester General Hospital, Leicester, UK; Diabetes Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
Diabetes Department, University Hospitals of Leicester NHS Trust, Leicester, UK.
Clin Med (Lond). 2025 Jan;25(1):100275. doi: 10.1016/j.clinme.2024.100275. Epub 2024 Dec 17.
With a rising worldwide incidence of obesity, particularly in the young, bariatric surgery offers an effective method of meaningful and sustained weight loss. At present, most bariatric procedures are carried out in women and increasingly in younger age groups. In line with the fertility benefits associated with weight loss, pregnancy after bariatric surgery is now a very common scenario. Although there is limited evidence to support optimal care in this group, most women appear to have good pregnancy outcomes, with reduced rates of pre-eclampsia and gestational diabetes (GDM). However, rates of stillbirth and small-for-gestational-age (SGA) babies are increased, suggesting that screening and supplementation of micronutrients is likely to be very important in this cohort. The risks and benefits that bariatric surgery may pose to pregnancy outcomes, both maternal and fetal, are largely dependent upon the degree of weight loss, weight stability upon entering pregnancy, surgical complications and the time interval between bariatric surgery and pregnancy. Ideally, preconception care would be more widely available, helping to assess and address micronutrient deficiencies and support preparation for pregnancy.
随着全球肥胖发病率的上升，尤其是在年轻人中，减肥手术提供了一种有效且能持续减重的方法。目前，大多数减肥手术是在女性中进行的，且越来越多地针对年轻人群体。鉴于减肥带来的生育益处，减肥手术后怀孕如今已很常见。尽管支持该群体最佳护理的证据有限，但大多数女性似乎有良好的妊娠结局，子痫前期和妊娠期糖尿病（GDM）的发生率降低。然而，死产和小于胎龄（SGA）儿的发生率增加，这表明在这一群体中筛查和补充微量营养素可能非常重要。减肥手术对母婴妊娠结局可能带来的风险和益处，很大程度上取决于体重减轻的程度、怀孕时的体重稳定性、手术并发症以及减肥手术与怀孕之间的时间间隔。理想情况下，孕前护理应更广泛地提供，以帮助评估和解决微量营养素缺乏问题，并支持备孕。
