Specialist care key to healthy pregnancies after bariatric surgery
Women who fall pregnant after bariatric surgery face unique health challenges with many missing out on the specialist support they need, according to new research from the Nepean Blue Mountains Local Health District.
The study, published in the journal Obesity Surgery, examined the pregnancy experiences of 189 women who had undergone metabolic and bariatric surgery before conceiving. The research found high rates of nutritional deficiencies and complications among both mothers and their babies.
Dr Kathryn Williams, Clinical Lead and Manager for the Nepean Family Metabolic Health Service says the findings highlight a need for stronger pre-pregnancy planning and ongoing specialist care.
“Bariatric surgery has many health benefits for patients with complex health needs. It can improve fertility, reduce diabetes risk and support a person’s long-term wellbeing,” says Kathryn, who is also one of the lead authors of the study.
“But our study shows that women who became pregnant after surgery often need extra help. Nutrient levels can drop quickly, and without close monitoring, this can affect the mother’s health and the baby’s development.”
Between January 2018 and July 2022, the team reviewed 210 pregnancies among 189 women who had previously undergone bariatric surgery. The average age was 32 years, and more than half were still living with obesity before pregnancy. Almost one in five conceived within a year of their operation (earlier than the 12-to-24 month window typically recommended).
The results revealed:
with admissions to special care nursery or the neonatal intensive care unit higher than for the background population.
Kathryn says that while many of these women are highly motivated and engaged with their health, gaps remain in coordinated care.
“Only about four in ten women in our study saw a dietitian before becoming pregnant.”
“That consultation prior to falling pregnant is a crucial opportunity to prevent deficiencies and plan for healthy pregnancies with positive outcomes. Every woman who’s had bariatric surgery deserves a clear pathway into specialised care and support,” explains Kathryn.
The research team also noted higher rates of mental health concerns, such as anxiety and depression among participants, underscoring the importance of holistic care that includes psychological as well as nutritional support.
Kathryn hopes the study can inform service improvements, including enhanced referral pathways and education for women considering pregnancy after bariatric surgery.
“Our message is one of empowerment, not alarm. With the right support team around them, be it obstetricians, dietitians, midwives, and psychologists, women can have healthy pregnancies and healthy babies after bariatric surgery.”
“At the Nepean Family Metabolic Health Service, we have an incredible multidisciplinary team who run our OPAL pregnancy clinic. This service is a midwife lead clinic that supports the health of women and their babies and helps address risks through regular monitoring and nutritional screening, as well as providing support for an active lifestyle and healthy diet.”
The research team hopes their findings will guide national recommendations on pregnancy care following metabolic and bariatric surgery.