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Pregnant Women Following Bariatric Surgery: a Focus on Maternal Mental Health and Its Impact on Birth Outcomes

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Abstract

Purpose

Bariatric surgery is associated with elevated risks for adverse birth outcomes, such as small-for-gestational-age infants (SGA). Maternal mental health is a critical regulator of fetal growth, but it is largely overlooked in pregnant women post-surgery. This study aimed to examine the associations between maternal mental health and birth outcomes in pregnant women post-bariatric surgery.

Materials and Methods

This was a retrospective analysis of medical records of women who had a singleton delivery following Roux-en-Y gastric bypass or sleeve gastrectomy. Mental health measures included depression/anxiety and substance use (cigarettes, alcohol, opioids, and marijuana). Birth outcomes were fetal growth restriction, SGA, low birthweight, and preterm birth. Logistic regressions were used to assess the associations between maternal mental health and each of the birth outcomes. A post hoc logistic regression was conducted to assess factors that influenced maternal marijuana use.

Results

Participants (N = 179) were mostly white (64.6%), non-Hispanic (84.5%), with a mean age of 32.7 ± 4.6 years, and mean body mass index of 37.2 ± 8.4 kg/m2 at conception. Maternal marijuana use significantly increased the odds for fetal growth restriction, SGA, low birthweight, and preterm birth. Cigarette use increased the risk for low birthweight. Conversely, alcohol use was protective of low birthweight and preterm birth. A post hoc analysis revealed that married women were less likely to use marijuana than those who were single, divorced, or widowed.

Conclusion

This analysis identified marijuana and cigarette use as risk factors for adverse birth outcomes post-bariatric surgery. Future studies with larger sample sizes are needed to confirm study findings.

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Author information

Authors and Affiliations

  1. School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA

    Yang Yu & Susan Groth

  2. Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd, Stanford, CA, 94305, USA

    Qianheng Ma

  3. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Stefanie Hollenbach

  4. Golisano College of Computing and Information Sciences, Rochester Institute of Technology, 20 Lomb Memorial Dr, Rochester, NY, 14623, USA

    Yuansheng Zhu

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  1. Yang Yu
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  4. Yuansheng Zhu
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Correspondence to Yang Yu.

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Key points

• Perinatal marijuana use increased the risk for various adverse birth outcomes.

• Perinatal cigarette use increased the risk for low birthweight post-surgery.

• Perinatal depression/anxiety was prevalent but not related to birth outcomes.

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Yu, Y., Ma, Q., Hollenbach, S. et al. Pregnant Women Following Bariatric Surgery: a Focus on Maternal Mental Health and Its Impact on Birth Outcomes. OBES SURG 32, 3696–3704 (2022). https://doi.org/10.1007/s11695-022-06283-7

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  • DOI: https://doi.org/10.1007/s11695-022-06283-7

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