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Pregnancy After Bariatric Surgery: Effects on Mother and Newborn

Yıl 2023, Cilt: 5 Sayı: 3, 452 - 466, 25.12.2023

Öz

Obesity, which has become a global public health problem, affects the health of many individuals negatively. It is known that it is effective in the emergence of sudden and long-term morbidities in terms of mother and newborn, especially by affecting the reproductive health of women. There is evidence that different surgical procedures performed within the scope of bariatric surgery, which is frequently preferred in the treatment of obesity in recent years, prevent some maternal and fetal complications in morbidly obese pregnant women. This review was conducted to evaluate the effects of bariatric surgery on mothers and newborns and the role of nurses in the follow-up of pregnancy after bariatric surgery. In the literature, it has been determined that there are risks such as micronutrient deficiencies and insufficient weight gain related to maternal health and fetal growth during pregnancy after bariatric surgery. In the studies conducted, the results of the positive effects of bariatric surgery in the treatment of obesity and its positive effects on maternal and newborn health are emphasized. It is reported that bariatric surgery improves pregnancy and fertility with safe pregnancy in terms of pregnancy complications such as preeclampsia, eclampsia, gestational diabetes, and it is safe for newborns in terms of risks such as shoulder dystocia, macrosomia, and birth asphyxia. It is thought that this review study will increase the awareness of nurses about the management of the pregnancy process after bariatric surgery and contribute to the integration of evidence-based practices in this field into nursing care.

Kaynakça

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Bariatrik Cerrahi Sonrası Gebelik: Anne ve Yenidoğan Üzerine Etkileri

Yıl 2023, Cilt: 5 Sayı: 3, 452 - 466, 25.12.2023

Öz

Günümüzde küresel bir halk sağlığı sorunu haline gelen obezite birçok bireyin sağlığını olumsuz yönde etkilemektedir. Özellikle kadınların üreme sağlığını etkileyerek anne ve yenidoğan açısından ani, uzun süreli morbiditelerin ortaya çıkmasında etkili olduğu bilinmektedir. Son yıllarda obezitenin tedavisinde sıklıkla tercih edilen bariatrik cerrahi kapsamında uygulanan farklı cerrahi prosedürlerin, morbid obez gebe kadınlarda bazı maternal ve fetal komplikasyonları önlediğine ilişkin kanıtlar bulunmaktadır. Bu derleme, bariatrik cerrahinin anneler ve yenidoğanlar üzerindeki etkilerini ve bariatrik cerrahi sonrası gebelik sürecinin takibinde hemşirenin rolünü değerlendirmek amacıyla yapılmıştır. Literatürde, bariatrik cerrahi sonrası gebelik sürecinde anne sağlığı ve fetal büyümeye ilişkin mikrobesin eksiklikleri, yetersiz kilo alımı gibi risklerin olduğu saptanmıştır. Yapılan çalışmalarda, bariatrik cerrahinin obezite tedavisindeki olumlu etkilerine bağlı anne ve yenidoğan sağlığını da olumlu yönde etkilediğine ilişkin sonuçlar vurgulanmaktadır. Bariatrik cerrahinin kadınlarda preeklampsi, eklampsi, gestasyonel diyabet, gibi gebelik komplikasyonları açısından güvenli gebelik ile doğurganlığı iyileştirdiği, omuz distosisi, makrozomi, doğum asfiksisi gibi riskler açısından da yenidoğanlar için güvenli olduğu bildirilmektedir. Bu derleme çalışmasının hemşirelerin bariatrik cerrahi sonrası gebelik sürecinin yönetimine ilişkin farkındalıklarını arttıracağı ve hemşireleri bu alandaki kanıt temelli uygulamaları hemşirelik bakımı içerisine entegre etmelerine katkıda bulunacağı düşünülmektedir.

Kaynakça

  • TUİK, Türkiye İstatistik Kurumu. (Erişim Tarihi: 24.06.2021). Türkiye Sağlık Araştırması 2019. https://data.tuik.gov.tr/Bulten/Index?p=Turkiye-Saglik-Arastirmasi-2019-33661.
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  • Adams, T., Hammoud, A., Davidson, L., Laferrère, B., Fraser, A., Stanford, J., . . . Taylor, D. (2015). Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. International journal of obesity, 39(4), 686-694.
  • Akhter, Z., Heslehurst, N., Ceulemans, D., Rankin, J., Ackroyd, R., & Devlieger, R. (2021). Pregnancy after Bariatric Surgery: A Nested Case-Control Study of Risk Factors for Small for Gestational Age Babies in AURORA. Nutrients, 13(5), 1699.
  • Akhter, Z., Rankin, J., Ceulemans, D., Ngongalah, L., Ackroyd, R., Devlieger, R., . . . Heslehurst, N. (2019). Pregnancy after bariatric surgery and adverse perinatal outcomes: A systematic review and meta-analysis. PLoS medicine, 16(8), e1002866.
  • Alatishe, A., Ammori, B., New, J., & Syed, A. (2013). Bariatric surgery in women of childbearing age. QJM: An International Journal of Medicine, 106(8), 717-720.
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  • Daşıkan, Z., & Kavlak, O. (2009). Maternal Obezite: Gebelik komplikasyonları ve gebe kadının yönetimi. Turkiye Klinikleri J Nurs Sci, 1(1), 39-46.
  • Davis, S., Chedraui, P., Lumsden, M., & Nappi, R. (2012). Understanding weight gain at menopause Understanding weight gain at menopause.
  • Ellsmere, J., Jones, D., & Chen, W. (2020). Late complications of bariatric surgical operations. In: Wolters Klumer: Kunnis L.
  • Falcone, V., Stopp, T., Feichtinger, M., Kiss, H., Eppel, W., Husslein, P. W., . . . Göbl, C. S. (2018). Pregnancy after bariatric surgery: a narrative literature review and discussion of impact on pregnancy management and outcome. BMC pregnancy and childbirth, 18(1), 1-13.
  • Gadani, R., Khaitan, M., Rekha, P., Hedge, A., Pokharel, K. N., & Khatri, V. (2021). Pregnancy Outcomes Post-bariatric Surgery—a Single-Centre Retrospective Study from India. Obesity Surgery, 1-8.
  • Gagnon, L. E., & Sheff, E. J. K. (2012). Outcomes and complications after bariatric surgery. AJN The American Journal of Nursing, 112(9), 26-36.
  • Galazis, N., Docheva, N., Simillis, C., & Nicolaides, K. H. (2014). Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 181, 45-53.
  • Gascoin, G., Gerard, M., Sallé, A., Becouarn, G., Rouleau, S., Sentilhes, L., & Coutant, R. (2017). Risk of low birth weight and micronutrient deficiencies in neonates from mothers after gastric bypass: a case control study. Surgery for Obesity and Related Diseases, 13(8), 1384-1391.
  • Gimenes, J. C., Nicoletti, C. F., de Souza Pinhel, M. A., Cortes-Oliveira, C., Júnior, W. S., & Nonino, C. B. (2018). Nutritional status of children from women with previously bariatric surgery. Obesity Surgery, 28(4), 990-995.
  • Gökosmanoğlu, F., Güzel, K., & Bayçelebi, G. (2020). Bariatrik Cerrahi Olgularında Preoperatif Değerlendirme Sırasında Tespit Edilen Hastalıkların Prevalansı. Sakarya Tıp Dergisi, 10(4), 650-654.
  • Graham, Y., Wilkes, S., Mansour, D., & Small, P. K. (2014). Contraceptive needs of women following bariatric surgery. Journal of Family Planning and Reproductive Health Care, 40(4), 241-244.
  • Greenberg, J. A., Bell, S. J., Guan, Y., & Yu, Y.-h. (2011). Folic acid supplementation and pregnancy: more than just neural tube defect prevention. Reviews in Obstetrics and Gynecology, 4(2), 52.
  • Guelinckx, I., Devlieger, R., Donceel, P., Bel, S., Pauwels, S., Bogaerts, A., . . . Vansant, G. (2012). Lifestyle after bariatric surgery: a multicenter, prospective cohort study in pregnant women. Obesity Surgery, 22(9), 1456-1464.
  • Harreiter, J., Schindler, K., Bancher-Todesca, D., Göbl, C., Langer, F., Prager, G., . . . Luger, A. (2018). Management of pregnant women after bariatric surgery. Journal of obesity, 2018.
  • Hazart, J., Le Guennec, D., Accoceberry, M., Lemery, D., Mulliez, A., Farigon, N., . . . Boirie, Y. (2017). Maternal nutritional deficiencies and small-for-gestational-age neonates at birth of women who have undergone bariatric surgery. Journal of pregnancy, 2017.
  • Heusschen, L., Krabbendam, I., van der Velde, J. M., Deden, L. N., Aarts, E. O., Merién, A. E., . . . Hazebroek, E. J. (2021). A matter of timing—pregnancy after bariatric surgery. Obesity Surgery, 31(5), 2072-2079.
  • Huang, B., Yo, J. H., Gandhi, S., & Maxwell, C. (2021). Micronutrient screening, monitoring, and supplementation in pregnancy after bariatric surgery. Obstetric Medicine, 1753495X211013624.
  • Husain, F., Jeong, I. H., Spight, D., Wolfe, B., & Mattar, S. G. (2018). Risk factors for early postoperative complications after bariatric surgery. Annals of surgical treatment and research, 95(2), 100-110.
  • Jans, G., Devlieger, R., De Preter, V., Ameye, L., Roelens, K., Lannoo, M., . . . Matthys, C. (2018). Bariatric surgery does not appear to affect women's breast-milk composition. The Journal of nutrition, 148(7), 1096-1102.
  • Jans, G., Matthys, C., Bogaerts, A., Ameye, L., Delaere, F., Roelens, K., . . . Verhaeghe, J. (2018). Depression and anxiety: lack of associations with an inadequate diet in a sample of pregnant women with a history of bariatric surgery—a Multicenter Prospective Controlled Cohort Study. Obesity Surgery, 28(6), 1629-1635.
  • Jans, G., Matthys, C., Bogaerts, A., Lannoo, M., Verhaeghe, J., Van der Schueren, B., & Devlieger, R. (2015). Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. Advances in Nutrition, 6(4), 420-429.
  • Jasaitis, Y., Sergent, F., Bridoux, V., Paquet, M., Marpeau, L., & Teniere, P. (2007). Management of pregnancies after adjustable gastric banding. Journal de gynecologie, obstetrique et biologie de la reproduction, 36(8), 764-769.
  • Johansson, K., Cnattingius, S., Näslund, I., Roos, N., Trolle Lagerros, Y., Granath, F., . . . Neovius, M. (2015). Outcomes of pregnancy after bariatric surgery. New England Journal of Medicine, 372(9), 814-824.
  • Kaidar-Person, O., Person, B., Szomstein, S., & Rosenthal, R. J. (2008). Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Obesity Surgery, 18(7), 870-876.
  • Kanj, R. V., Schwartz, B. I., Alexander, M., Barth, J. F., Hoefgen, H. R., Trotman, G. E., & Breech, L. L. (2016). Continuation rates and satisfaction with the levonorgestrel intrauterine device in nulliparous adolescents undergoing bariatric surgery. Journal of Pediatric and Adolescent Gynecology, 29(2), 203-204.
  • Kaska, L., Kobiela, J., Abacjew-Chmylko, A., Chmylko, L., Wojanowska-Pindel, M., Kobiela, P., . . . Stefaniak, T. (2013). Nutrition and pregnancy after bariatric surgery. International Scholarly Research Notices, 2013.
  • Kim, S. Y., Dietz, P. M., England, L., Morrow, B., & Callaghan, W. M. (2007). Trends in pre‐pregnancy obesity in nine states, 1993–2003. Obesity, 15(4), 986-993.
  • Kochhar, S. (2016). UK medical eligibility criteria for contraceptive use. Independent Nurse, 2016(13), 16-18.
  • Lapolla, A., Marangon, M., Dalfrà, M. G., Segato, G., De Luca, M., Fedele, D., . . . Busetto, L. (2010). Pregnancy outcome in morbidly obese women before and after laparoscopic gastric banding. Obesity Surgery, 20(9), 1251-1257.
  • Lim, R., Beekley, A., Johnson, D. C., & Davis, K. A. (2018). Early and late complications of bariatric operation. Trauma surgery & acute care open, 3(1), e000219.
  • Lim, R. B., Jones, D., & Chen, W. (2017). Bariatric operations: Perioperative morbidity and mortality. UpToDate. 2017. In: Waltham, MA.
  • Luyssen, J., Jans, G., Bogaerts, A., Ceulemans, D., Matthys, C., Van der Schueren, B., . . . Lannoo, L. (2018). Contraception, menstruation, and sexuality after bariatric surgery: a prospective cohort study. Obesity Surgery, 28(5), 1385-1393.
  • Magdaleno, R., Pereira, B. G., Chaim, E. A., & Turato, E. R. (2012). Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges. Archives of gynecology and obstetrics, 285(3), 559-566.
  • Maggard, M. A., Yermilov, I., Li, Z., Maglione, M., Newberry, S., Suttorp, M., . . . Livingston, E. H. (2008). Pregnancy and fertility following bariatric surgery: a systematic review. JaMa, 300(19), 2286-2296.
  • Maxwell, C., Gaudet, L., Cassir, G., Nowik, C., McLeod, N. L., Jacob, C.-É., & Walker, M. (2019). Guideline no. 391-pregnancy and maternal obesity part 1: Pre-conception and prenatal care. Journal of Obstetrics and Gynaecology Canada, 41(11), 1623-1640.
  • McGuire, S. (2013). IOM (Institute of Medicine) and NRC (National Research Council). 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press, 2013. Advances in Nutrition, 4(4), 477-478.
  • Mechanick, J. I., Apovian, C., Brethauer, S., Garvey, W. T., Joffe, A. M., Kim, J., . . . Seger, J. (2020). Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures–2019. Surgery for Obesity and Related Diseases, 16(2), 175-247.
  • Mengesha, B., Griffin, L., Nagle, A., & Kiley, J. (2016). Assessment of contraceptive needs in women undergoing bariatric surgery. Contraception, 94(1), 74-77.
  • Menke, M. N., King, W. C., White, G. E., Gosman, G. G., Courcoulas, A. P., Dakin, G. F., . . . Pories, W. J. (2017). Contraception and conception after bariatric surgery. Obstetrics and gynecology, 130(5), 979.
  • Monson, M., & Jackson, M. (2016). Pregnancy after bariatric surgery. Clinical obstetrics and gynecology, 59(1), 158-171.
  • O'Kane, M., Parretti, H. M., Hughes, C. A., Sharma, M., Woodcock, S., Puplampu, T., . . . Joyce, J. (2016). Guidelines for the follow‐up of patients undergoing bariatric surgery. Clinical obesity, 6(3), 210-224.
  • Obstetricians, A. C. o., & Gynecologists. (2013). ACOG Committee opinion no. 549: obesity in pregnancy. Obstetrics and gynecology, 121(1), 213-217.
  • Obstetriciansgynecologists, A. (2009). ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol, 113(6), 1405-1413.
  • Onesimo, R., Proli, F., Leoni, C., Contaldo, I., Salerni, A., Conti, G., . . . Zampino, G. (2021). Embryopathy Following Maternal Biliopancreatic Diversion: Is Bariatric Surgery Really Safe? Obesity Surgery, 31(1), 445-450.
  • Östlund, M. P., Backman, O., Marsk, R., Stockeld, D., Lagergren, J., Rasmussen, F., & Näslund, E. (2013). Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery. JAMA surgery, 148(4), 374-377.
  • Parent, B., Martopullo, I., Weiss, N. S., Khandelwal, S., Fay, E. E., & Rowhani-Rahbar, A. (2017). Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications. JAMA surgery, 152(2), 128-135.
  • Pham, T. Q., Pigeyre, M., Caiazzo, R., Verkindt, H., Deruelle, P., & Pattou, F. (2015). Does pregnancy influence long-term results of bariatric surgery? Surgery for Obesity and Related Diseases, 11(5), 1134-1139.
  • Rives-Lange, C., Girardeau, Y., Poghosyan, T., Ciangura, C., Coupaye, M., Nizard, J., . . . Czernichow, S. (2021). Change in Birth Rate Before and After Bariatric Surgery in France. Obesity Surgery, 1-5.
  • Robinson, J. A., & Burke, A. E. (2013). Obesity and hormonal contraceptive efficacy. Women’s health, 9(5), 453-466.
  • Rottenstreich, A., Elazary, R., Goldenshluger, A., Pikarsky, A. J., Elchalal, U., & Ben-Porat, T. (2019). Maternal nutritional status and related pregnancy outcomes following bariatric surgery: a systematic review. Surgery for Obesity and Related Diseases, 15(2), 324-332.
  • Różańska-Walędziak, A., Bartnik, P., Kacperczyk-Bartnik, J., Czajkowski, K., Walędziak, M., & Kwiatkowski, A. (2021). Pregnancy after bariatric surgery–a narrative literature review. Videosurgery and Other Miniinvasive Techniques, 16(1), 30.
  • Saltzman, E., & Philip Karl, J. (2013). Nutrient deficiencies after gastric bypass surgery. Annual review of nutrition, 33, 183-203.
  • Santulli, P., Mandelbrot, L., Facchiano, E., Dussaux, C., Ceccaldi, P.-F., Ledoux, S., & Msika, S. (2010). Obstetrical and neonatal outcomes of pregnancies following gastric bypass surgery: a retrospective cohort study in a French referral centre. Obesity Surgery, 20(11), 1501-1508.
  • Schlatter, J. (2017). Oral contraceptives after bariatric surgery. Obesity facts, 10(2), 118-126.
  • Scholtz, S., Balen, A., & Le Roux, C. (2015). The role of bariatric surgery in improving reproductive health. Royal College of Obstetricians and Gynaecologists: London, UK.
  • Sha, Y. (2021). Implication of Bariatric Surgery for Breastfeeding: Maternal Nutrition, Milk Composition, and Milk Production-A Care Guide Review for Registered Dietitians and Lactation Consultants. University of North Carolina at Chapel Hill,
  • Shawe, J., Ceulemans, D., Akhter, Z., Neff, K., Hart, K., Heslehurst, N., . . . Taheri, S. (2019). Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care. Obesity Reviews, 20(11), 1507-1522.
  • Sheiner, E., Levy, A., Silverberg, D., Menes, T. S., Levy, I., Katz, M., & Mazor, M. (2004). Pregnancy after bariatric surgery is not associated with adverse perinatal outcome. American journal of obstetrics and gynecology, 190(5), 1335-1340.
  • Stentebjerg, L. L., Andersen, L. L. T., Renault, K., Støving, R. K., & Jensen, D. M. (2017). Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass. The Journal of Maternal-Fetal & Neonatal Medicine, 30(10), 1182-1188.
  • Van De Maele, K., Bogaerts, A., De Schepper, J., Provyn, S., Ceulemans, D., Guelinckx, I., . . . Devlieger, R. (2021). Adiposity, psychomotor and behaviour outcomes of children born after maternal bariatric surgery. Pediatric Obesity, 16(5), e12749.
  • Vynckier, A.-K., Ceulemans, D., Vanheule, G., De Mulder, P., Van Den Driessche, M., & Devlieger, R. (2021). Periconceptional Folate Supplementation in Women after Bariatric Surgery—A Narrative Review. Nutrients, 13(5), 1557.
  • Webber, J., Charlton, M., & Johns, N. (2015). Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period (NG3). British Journal of Diabetes, 15(3), 107-111.
  • Willis, K., Lieberman, N., & Sheiner, E. (2015). Pregnancy and neonatal outcome after bariatric surgery. Best practice & research Clinical obstetrics & gynaecology, 29(1), 133-144.
  • WHO, World Health Organization. (Erişim Tarihi: 24.06.2021a). http://www.assessmentpsychology.com/icbmi.htm. Retrieved from http://www.assessmentpsychology.com/icbmi.htm
  • WHO, World Health Organization. (Erişim Tarihi: 24.06.2021b). Obezity and Owerweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  • Yi, X.-y., Li, Q.-f., Zhang, J., & Wang, Z.-h. (2015). A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery. International Journal of Gynecology & Obstetrics, 130(1), 3-9.
Toplam 88 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Fazilet Tamer 0000-0002-8997-9141

Füsun Terzioğlu 0000-0002-4082-7059

Erken Görünüm Tarihi 23 Aralık 2023
Yayımlanma Tarihi 25 Aralık 2023
Gönderilme Tarihi 20 Temmuz 2022
Kabul Tarihi 8 Aralık 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 5 Sayı: 3

Kaynak Göster

APA Tamer, F., & Terzioğlu, F. (2023). Bariatrik Cerrahi Sonrası Gebelik: Anne ve Yenidoğan Üzerine Etkileri. Genel Sağlık Bilimleri Dergisi, 5(3), 452-466.

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