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Women's Health: Weight-loss surgery may benefit pregnancy plans

Complication risks could be lower in extremely obese women who have the procedure

A small study suggests that obese women may benefit from undergoing weight-loss surgery before getting pregnant: It could reduce their risk of complications.

Dr. Susan Stein, a research fellow in the department of gynecology at the Mayo Clinic in Scottsdale, Ariz., notes that older studies linked obesity surgery with pregnancy complications such as gastrointestinal bleeding, hernias, vitamin deficiencies and even death of the mother or baby. But more recent reports have suggested the procedure is safe. In fact, 80 per cent of the 100,000 weight-loss surgeries performed in the U.S. in 2003 were on women of reproductive age.

Stein and her colleagues reviewed the cases of 19 extremely obese women who got pregnant following weight-loss surgery, and compared them with 38 similar pregnant women who had not had the surgery, which involved decreasing the size of the stomach and bypassing a portion of the small intestine.

Most of the 19 women got pregnant several years after the surgery, when their weight had stabilized, but two women had undergone the surgery less than a year earlier and were still losing weight during pregnancy. Although experts recommend waiting a minimum of 12 to 24 months after weight-loss surgery before becoming pregnant, Stein says the average rate of pregnancy in the 12 months following the procedure is 3.3 per cent.

In the study, women who had had the surgery were less likely to have pre-pregnancy high blood pressure than those who had not. During pregnancy, they were also less likely to develop pre-eclampsia (a serious complication involving high blood pressure and protein in the urine) and oligohydramnios (a deficiency of amniotic fluid). On the downside, women who had undergone surgery were more likely to develop anemia, a shortage of red blood cells.

The researchers concluded that pregnancy appears to be safe in women who have undergone weight-loss surgery, and may be associated with fewer complications. However, they point out that larger studies involving different types of obesity surgery are needed.

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