Mental health during pregnancy and postpartum in women with a history of bariatric surgery: A scoping review

PURPOSE: With rising bariatric surgery rates, more women of childbearing age are becoming pregnant after bariatric surgery. Bariatric surgery is often associated with psychological diagnoses. While mental health issues are common during pregnancy and postpartum, the effects of bariatric surgery on mental health during these periods is unclear. This review aimed to collate and synthesise available literature regarding the impact of bariatric surgery on mental health during pregnancy and postpartum. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews framework. A systematic search was conducted across five databases (MEDLINE, Embase, CINAHL, Maternity and Infant Care, and Global Health). It included peer-reviewed primary research studies and conference abstracts published in English that reported mental health outcomes of women during pregnancy and postpartum with histories of bariatric surgery. There were no time restrictions for including studies. A narrative synthesis following the Popay et al. framework was performed to summarise and interpret the findings. RESULTS: The available evidence suggest that women who have undergone bariatric surgery may be at increased risk of experiencing depression and anxiety during pregnancy compared to women who have not had bariatric surgery. Factors such as marital status, psychiatric history, and smoking exacerbate these risks. Evidence regarding other mental health disorders and postpartum depression was limited and inconsistent. CONCLUSIONS: Pre-pregnancy bariatric surgery may increase the risk of mental health challenges during the perinatal period. Mental health assessments should be integrated into antenatal and postnatal care for women with bariatric surgery histories.