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Anemia during pregnancy after silastic ring Roux-en-Y gastric bypass: influence of time to conception
Roseli Mieko Yamamoto Nomura1, Maria Carolina Gonçalves Dias, Ana Maria Kondo Igai
1Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, Av Dr Enéas de Carvalho Aguiar 255, São Paulo, SP, Brazil. roseli.nomura@hotmail.com
Background:
Bariatric surgery before pregnancy may help prevent obesity-related gestational complications. However, maternal malnutrition is not without potential risks during pregnancy. The objective was to evaluate the influence of time to conception after silastic ring Roux-en-Y gastric bypass (SRYGB) on maternal anemia.
Methods:
Patients who underwent SRYGB for morbid obesity and who subsequently became pregnant were followed up at the prenatal. Thirty pregnancies occurred between July 2001 and September 2009. The patients were analyzed according to time to conception after bariatric surgery: 17 patients with time to conception <4 years (48 months) and 13 patients with ≥ 4 years.
Results:
First trimester hemoglobin levels were significantly lower in patients with time to conception ≥ 4 years (48 months) (median 9.6 g/dL, range 5.8-13.2 g/dL) than in patients with time to conception <4 years (median 11.1 g/dL, range 9.8-13.6 g/dL; p=0.047). The need for intravenous iron therapy or packed red cell transfusion was significantly more frequent among women who became pregnant ≥ 4 years after SRYGB compared to <4 years (30.8% vs. 0%, p=0.026).
Conclusion:
Pregnancy after 4 years of SRYGB is associated with maternal anemia and the need for more strict iron supplementation.
