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Normal Birth Outcomes After Laparoscopic Gastric Banding

Results from a small study suggest that pregnancy is relatively safe in women with adjustable gastric bands.

As the number of morbidly obese women of reproductive age increases, more women are conceiving after obesity surgery. Australian investigators examined outcomes in 79 consecutive pregnancies (>20 weeks’ gestation) in women who had undergone laparoscopic adjustable gastric banding (LAGB). These outcomes were compared with those in 40 pre-LAGB pregnancies in the same women; 79 pregnancies in morbidly obese comparison women; and 61,000 pregnancies in the community. All women undergoing LAGB were advised to take multivitamins that contained folate and to take additional folate if they were contemplating pregnancy.

Mean weight gain during pregnancy was significantly lower after LAGB (9.6 kg) than before LAGB (14.4 kg) or in obese comparison women (15.5 kg). The incidence of pregnancy-induced hypertension also was significantly lower after LAGB (10% vs. 45% and 38%, respectively). The incidence of gestational diabetes in the three groups was 6.3%, 15%, and 19%, respectively; the difference between post-LAGB and obese-comparison groups was significant. Incidences of pregnancy-induced hypertension and diabetes after LAGB were comparable to those seen in the community. Mean birth weights were similar in all groups. Maternal weight gain was better controlled in women who were monitored during pregnancy and who underwent band adjustments when indicated. Neonatal outcomes after LAGB were consistent with those observed for the community.

Comment: Small series such as this one provide some reassurance that pregnancy is relatively safe in women who undergo laparoscopic adjustable gastric banding. However, larger prospective trials are needed to determine more definitively whether any increased risks are associated with pregnancy in these women.

— Robert W. Rebar, MD

Published in Journal Watch General Medicine November 22, 2005

Citation(s):

Dixon JB et al. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 2005 Nov; 106:965-72.

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