Pregnancy, Perinatal, and Fertility Outcomes Following Bariatric Surgery

The worldwide obesity epidemic has had a profound impact on maternal-fetal medicine. At the time of conception, one in five women are obese. The rate of women seeking bariatric surgery for weight loss is increasing, with some reports suggesting that women make up nearly three-quarters of the post-bariatric population. Several large population-based studies comparing pregnancies preoperatively and postoperatively have elucidated the impact of bariatric surgery on maternal and fetal outcomes. Bariatric surgery seems to lower the risk of complications such as gestational diabetes mellitus, hypertensive disorders of pregnancy, and large-for-gestational-age (LGA) infants. However, women who become pregnant after bariatric surgery may have an increased risk of small-for-gestational-age (SGA) infants. It is still unclear whether bariatric surgery influences rates of miscarriage and preterm delivery. This chapter summarizes the existing literature regarding bariatric surgery and reproductive health, and provides a guide for the clinician who is involved with the postoperative management of these women.