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Embryopathy Following Maternal Biliopancreatic Diversion: Is Bariatric Surgery Really Safe?

Roberta Onesimo1, Francesco Proli1, Chiara Leoni1

  • 1Rare Disease and Birth Defects Unit, Department of Woman, Child Health and Public Health, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

Obesity Surgery
|July 29, 2020
PubMed

Pregnancy after bariatric surgery is usually considered safe. Recently, a few studies reported that bariatric surgery represents a risk factor for birth defects. A case series of six patients, born from women who had undergone biliopancreatic diversion, is reported. The clinical pattern was characterized by psychomotor development delay (100%), microphthalmia (83%), growth retardation (66%), hearing loss (66%), and variable facial dysmorphism. Based on the clinical profile and symptoms reported by women during pregnancy, a causal association between maternal chronic post-surgical malabsorption, congenital anomalies, and neonatal outcome is proposed, with vitamin A deficiency representing a major causing factor. Educational follow-up support, continuous clinical monitoring, and appropriate nutritional assessment appear to be crucial to reduce the potential risk of congenital malformations and child disability.

Keywords:
Biliopancreatic diversionEmbryopathyNutritionObesity surgery safenessVitamin A deficiency

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