Pregnancy Outcomes After Metabolic Bariatric Surgery According to the Surgery-to-Conception Interval: A Multicentre...

Metabolic bariatric surgery (MBS) improves fertility in women with severe obesity, raising concerns regarding the optimal timing of conception. Current guidelines recommend postponing pregnancy for 12-24 months after surgery; however, evidence on the impact of the surgery-to-conception interval on pregnancy outcomes remains limited.

This retrospective observational cohort study was conducted within a multicenter research framework investigating pregnancy outcomes after MBS. Data from 156 women who conceived after MBS between 2015 and 2024 were collected from eleven accredited bariatric centers. Participants were stratified according to the interval between surgery and conception: <12 months, 12-24 months, and >24 months. Maternal outcomes included gestational diabetes mellitus, pregnancy-induced hypertension, pre-eclampsia, mode of delivery, and gestational weight gain (GWG). Neonatal outcomes comprised gestational age at delivery, birthweight, and Apgar scores. Group comparisons were performed using the Kruskal-Wallis test and Pearson's chi-square test.

Among the 156 pregnancies analyzed, 41 occurred within <12 months, 71 within 12-24 months, and 44 after >24 months following surgery. Sleeve gastrectomy was the predominant procedure. No statistically significant differences were observed between groups in maternal complications, mode of delivery, gestational age at birth, birthweight, or Apgar scores (all p > 0.05). Gestational weight gain tended to be lower in pregnancies conceived within 12 months, without reaching statistical significance.

The surgery-to-conception interval was not significantly associated with adverse maternal or neonatal outcomes in this cohort. Pregnancy planning after bariatric surgery should be individualized based on postoperative weight stabilization and nutritional status rather than a fixed time threshold; confirmation in larger prospective studies is warranted.