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Pregnancy After Bariatric Surgery

To identify the key insights or developments described in this article
1 Credit CME

Obesity affects 39.7% of reproductive-aged females (body mass index [BMI] ≥30) in the US, with a rising prevalence over the past 2 decades.1 Prepregnancy obesity is associated with an increased risk of almost all pregnancy complications, including gestational diabetes, hypertensive disorders of pregnancy, small for gestational age (SGA) or large for gestational age (LGA) neonates, congenital anomalies, and cesarean delivery.2,3 Obesity has health implications for the offspring due to changes in developmental programming in utero, contributing to increasing rates of childhood obesity and related comorbidities later in life.3,4

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Article Information

Corresponding Author: Michelle A. Kominiarek, MD, MS, Department of Obstetrics and Gynecology, Prentice Women’s Hospital, Northwestern University Feinberg School of Medicine, 250 E Superior St, Ste 05-2149, Chicago, IL 60611 (mkominia@nm.org).

Published Online: February 10, 2023. doi:10.1001/jama.2023.1442

Conflict of Interest Disclosures: None reported.

References
1.
Hales  CM , Carroll  MD , Fryar  CD , Ogden  CL . Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. National Center for Health Statistics; 2020.
2.
 ACOG Practice Bulletin No. 105: bariatric surgery and pregnancy.   Obstet Gynecol. 2009;113(6):1405-1413. doi:10.1097/AOG.0b013e3181ac0544PubMedGoogle ScholarCrossref
3.
Falcone  V , Stopp  T , Feichtinger  M ,  et al.  Pregnancy after bariatric surgery.   BMC Pregnancy Childbirth. 2018;18(1):507.PubMedGoogle ScholarCrossref
4.
Shawe  J , Ceulemans  D , Akhter  Z ,  et al.  Pregnancy after bariatric surgery: consensus recommendations for periconception, antenatal and postnatal care.   Obes Rev. 2019;20(11):1507-1522.PubMedGoogle ScholarCrossref
5.
Akhter  Z , Rankin  J , Ceulemans  D ,  et al.  Pregnancy after bariatric surgery and adverse perinatal outcomes: a systematic review and meta-analysis.   PLoS Med. 2019;16(8):e1002866.PubMedGoogle Scholar
6.
Parent  B , Martopullo  I , Weiss  NS ,  et al.  Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated perinatal complications.   JAMA Surg. 2017;152(2):128-135.PubMedGoogle ScholarCrossref
7.
Mechanick  JI , Apovian  C , Brethauer  S ,  et al.  Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures: 2019 update.   Endocr Pract. 2019;25(12):1346-1359.PubMedGoogle Scholar
8.
Abbassi-Ghanavati  M , Greer  LG , Cunningham  FG .  Pregnancy and laboratory studies.   Obstet Gynecol. 2009;114(6):1326-1331.PubMedGoogle ScholarCrossref
9.
Rasmussen KM, Yaktine AL, eds. Weight Gain During Pregnancy: Reexamining the Guidelines. National Academies Press; 2009.
10.
Kim  J , Kelley  J , Davidson  L ,  et al.  Depression and anxiety incidence during pregnancy between bariatric surgery patients and matched control subjects.   Obes Surg. 2022;32(6):1962-1968.PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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