According to a survey conducted by the CDC in 2016-2017, 27.4% of women in the United States ages 18-44 had a Body Mass Index (BMI) of 30 or higher based on reported height and weight. Put simply, almost a third of U.S. women of reproductive age are considered obese, and will most likely face a host of health complications that arise during pregnancy. Here’s how obesity affects pregnancy and what a recent study suggests about the role of weight loss surgery in promoting safer childbirth.
How Does Obesity Affect Pregnancy?
Women with obesity have a higher risk of developing adverse health conditions ranging from decreased fertility to complications during pregnancy. These complications include gestational diabetes, preeclampsia, sleep apnea, and an increased risk of stillbirth and miscarriage. During delivery, obese women are more likely to require a C-section due to prolonged and complicated labors. They are also more susceptible to infection and postpartum hemorrhage that often accompany a C-Section procedure.
How Can Bariatric Surgery Promote Safer Childbirth?
Research has shown that weight loss surgery before pregnancy can improve the metabolic conditions of mothers-to-be, boost fertility, and help decrease the risk of gestational diabetes and hypertension. Now, recent research suggests that weight loss resulting from bariatric surgery could also lead to safer deliveries.
A study from the Karolinska Institutet’s Department of Medicine in Solna, Sweden observed and compared the deliveries of two sets of women. In the first group were women who had undergone bariatric surgery and had lost a significant amount of weight before their pregnancies. In the second group were those who had comparable BMIs to the first group pre-surgery and had not had surgery.
According to Dr. Olof Stephansson of the research team, the differences in outcomes were significant and favorable for the group who had undergone bariatric surgery. In these women’s deliveries, he and colleagues observed a lower occurrence of C-sections and a decrease in delivery inductions, which are often necessary when a pregnancy has gone post-term. Besides, they noted fewer instances of vaginal delivery-related complications including tearing, bleeding, and infection.
The results seem to suggest that substantial weight loss after bariatric surgery resulted in safer delivery procedures for the women. And while Dr. Stephansson is optimistic, he does acknowledge that more extensive and widespread research is needed so that a definitive conclusion can be drawn. He stresses the importance of a comprehensive approach where health professionals in different specialties work together to produce positive outcomes for patients.
Dr. Balsama is fully committed to patient well-being in and out of the operating room. If you are considering weight loss surgery before pregnancy or have any questions, contact Dr. Balsama for a consultation. Once you have achieved weight loss after eighteen months, you can become pregnant.
Olof Stephansson, Kari Johansson, Jonas Söderling, Ingmar Näslund, Martin Neovius. Delivery outcomes in term births after bariatric surgery: Population-based matched cohort study. PLOS Medicine, 2018; 15 (9): e1002656 DOI: 10.1371/journal.pmed.1002656