Overweight and Planning Pregnancy
Gastric Bypass before Pregnancy May Reduce Pregnancy Complications
Dec 5, 2008
If you are considering pregnancy soon but you are substantially overweight, what do you need to know? The first thing is that you are not alone. The rate of obesity has climbed most considerably in the United States, England and Canada in last several years. While obesity does not guarantee you will have a more difficult pregnancy, it can increase your pregnancy and childbirth risks. What do you need to know about being substantially overweight when you are planning to become pregnant?
Obesity Statistics in Women
While 63% of people are considered to be overweight in the US, the most recent statistics indicate that around 30% of people are in the obese category. By definition, anyone with a body mass index (BMI) over 30 is considered to be obese. Of the women in the 16-24 age bracket, about 27% of them fall into the obese category. Women who are in the "super obese" category comprise about 1 in every 16 women.
Increased Pregnancy and Labor Complications with Obesity
Obesity has been shown to increase a number of complications during pregnancy, including gestational diabetes, and preeclampsia. Obesity is also associated with more complications with labor including macrosomia (large babies), shoulder dystocia and increased cesareans.
Reducing Pregnancy Complications with Gastric Bypass Surgery
Could women benefit from losing weight prior to pregnancy? The answer is unequivocally "yes." However losing large amounts of weight might feel like fighting a losing battle for many women who are obese.
Is bariatric surgery/gastric bypass an effective way to help women not only lose additional pounds but reduce pregnancy and labor complications? A systematic review of 75 studies on bariatric surgery appeared in the November 2008 Journal of the American Medical Association. Researchers looked at the results from women in the 18 to 45 age bracket who elected to have gastric bypass. According to this research, between 2003 and 2005, 50,000 women chose to have bariatric surgery each year.
Results of the study showed that pregnancy complications were reduced following gastric bypass including risks of gestational diabetes, preeclampsia and lower maternal weight gain. Babies were also healthier with fewer instances of low birthweight, preterm birth and macrosomia among the mothers who underwent gastric bypass. Researchers advised that more information regarding fertility after weight loss and nutritional aspects of pregnancy is needed.
The Risks versus Benefits of Bariatric Surgery
Just like any surgery, gastric bypass is not without its own set of risks and complications. Statistics show that the risk of death within 30 days after surgery is anywhere from 1 in 500 to 1 in 50. (The higher death rates are more likely to occur with surgeons who have the least experience.) Studies have shown that the group most likely to benefit from gastric bypass were under the age of 40 and morbidly obese. A 13 year study found that 3% of those receiving gastric bypass died versus 14% of morbidly obese people who did not receive the surgery.
If you are a young woman whose weight is in the obese or morbidly obese category and you are considering pregnancy in the near future, be sure to talk to your care provider about the risks versus benefits of gastric bypass.
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