Pregnancy and neonatal outcomes following sleeve gastrectomy vs. Roux-en-Y gastric bypass: a retrospective cohort study

Bariatric metabolic surgery (BMS) is increasingly preferred for women of reproductive age with morbid obesity due to its impact on weight and comorbidities. However, the physiological and nutritional changes after surgery may influence pregnancy outcomes. Among common procedures, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) differ in anatomical and metabolic aspects, potentially leading to distinct perinatal risks. This study compared pregnancy and neonatal outcomes between these two procedures. A total of 53 women who became pregnant after undergoing SG (n = 38) or RYGB (n = 15) between January 2018 and January 2022 were included in this study. Data were retrieved from institutional medical records and the national e-health system. Demographic characteristics, obstetric parameters, and neonatal outcomes were compared between the two groups. Exclusion criteria included twin pregnancies, irregular follow-up, and incomplete data. Statistical analyses were conducted using appropriate parametric or non-parametric tests based on data distribution. A p-value of < 0.05 was considered statistically significant. The mean age of the study population was 28.3 ± 5.2 years. The mean interval from surgery to conception was 33 months. Miscarriage risk was higher in the RYGB group compared to the SG group (OR: 41.35, 95% CI: 3.92–436.61, p < 0.001). The two groups demonstrated comparable rates of preterm delivery, gestational diabetes mellitus, hypertensive disorders, anemia, as well as similar neonatal birth weight, head circumference, and NICU admission frequencies. However, the SG group exhibited greater gestational weight gain (p = 0.001) and higher postpartum BMI (p = 0.042). Both SG and RYGB appear to be safe options for women of childbearing age. SG was linked to higher gestational weight gain, while RYGB showed a higher risk of miscarriage. These findings highlight the need for individualized counseling and close follow-up. Further prospective studies are needed to clarify long-term reproductive effects.