Maternal and neonatal outcomes after bariatric surgery in pregnancy: a cohort study comparing women with and without prior bariatric surgery

Pregnant women with obesity are at increased risk of adverse maternal and neonatal outcomes, including gestational diabetes and hypertensive disorders. Although bariatric surgery is an effective long-term treatment for obesity, its effects on pregnancy and postpartum outcomes remain incompletely understood. This retrospective cohort study aimed to evaluate the impact of bariatric surgery on maternal and neonatal outcomes. The study was conducted between May 2022 and January 2024 at national obesity and healthcare clinics and included 170 pregnant women, of whom 87 had a history of bariatric surgery and 83 had obesity without prior surgery. Data were collected using questionnaires, interviews, and labor records. Adjusted regression analyses were performed using SPSS version 22. After adjustment for potential confounders, pregnancies following bariatric surgery were associated with a higher risk of maternal anemia (P = .003) and a lower incidence of large for gestational age infants (P = .030). The surgical group also delivered at an earlier gestational age (P = .001) and had infants with lower birth weights (P = .049) than the controls group. No significant differences were found in oligohydramnios, polyhydramnios, pregnancy-induced hypertension, or hyperemesis gravidarum. Therefore, pregnancies in women with a history of bariatric surgery were associated with a higher risk of anemia, lower gestational age, and lower birth weight compared to women with obesity, but a lower incidence of delivering a large-for-gestational-age infant.