As obesity rates increase, more women of childbearing age opt for surgical intervention for weight loss. The objective of this study was to evaluate whether the mechanism of weight loss related to the type of bariatric surgery (malabsorptive vs. restrictive type) impacts pregnancy outcomes.
IRB approval was obtained. This was a single center, retrospective cohort study of 182 singleton pregnancies after bariatric surgery that delivered between 2006 and 2019. Women were separated based on malabsorptive or restrictive type of procedure. Pregnancy outcomes were compared using univariable and multivariable analyses.
Of the 182 patients, 41 women had a restrictive procedure and 141 had a malabsorptive procedure. Women with malabsorptive procedures were more likely to have a baseline vitamin deficiency (72.0% vs 35.3%, P=.001), a lower early pregnancy BMI (34.3±6.7 vs 39.2±9.1, P=.001), and anemia at term (59.4% vs 33.3%, P=.004). A maternal composite outcome was not higher in malabsorptive versus restrictive surgeries (7.1% vs 2.4%, P=.271). A composite fetal outcome was also not higher in the malabsorptive group (27.7% vs 34.2%, P=.421). In multivariable analysis, there were no differences in maternal or neonatal outcomes between groups, although there was a trend for higher rates of SGA infants in the malabsorptive group (aOR 4.85, 95% CI 0.58–40.63).
The type of bariatric procedure does not impact neonatal outcomes, rate of GDM or hypertension in pregnancy, or mean GA at delivery. Women with a malabsorptive procedure were frequently vitamin deficient, anemic, and had lower BMI in early pregnancy.