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Women’s Health

Bariatric surgery before pregnancy reduces the risk of gestational diabetes in obese women Gestational diabetes mellitus (GDM) occurs in at least 7 percent of pregnancies in the United States and is associated with increased risk of adverse outcomes for fetus and mother, including subsequent development of adult-onset (type 2) diabetes in the mother and obesity in the offspring. Obese women who have surgery to lose weight (bariatric surgery) before becoming pregnant are 77 percent less likely to suffer from gestational diabetes mellitus (GDM) during pregnancy than obese women who do not have this surgery before their pregnancy, concludes a new study. In addition, women who undergo bariatric surgery before pregnancy are 52 percent less likely to require cesarean section (an outcome associated with GDM) during delivery than women who delivered before having bariatric surgery. The majority of women in each treated group had a gastric bypass procedure (75 percent for the postdelivery group and 87 percent for the predelivery group). The adjustable-band procedure was more common postdelivery (9 percent) than predelivery (3 percent). The researchers retrospectively analyzed private insurance data from Blue Cross affiliates in seven States for women who had procedure codes for bariatric surgery between 2002 and 2006, and a service date for either a delivery or a pregnancy loss. The final study included 700 women who had bariatric surgery and a delivery, but not pre-existing diabetes (346 who delivered before bariatric surgery and 354 who delivered after such surgery). If future, prospective studies confirm the effectiveness of predelivery bariatric surgery in reducing the incidence of GDM, the procedure could be considered as a preventive health intervention for obese women of childbearing age, suggest the researchers. Their study was funded in part by the Agency for Healthcare Research and Quality (Contract No. 290-05-0034). More details are in “Reduced incidence of gestational diabetes with bariatric surgery,” by Anne E. Burke, M.D., M.P.H., Wendy L. Bennett, M.D., M.P.H., Roxanne M. Jamshidi, M.D., M.P.H., and others in the August 2010 Journal of the American College of Surgeons 211(2), pp. 169-175.