The long-term effect of pregnancy on weight loss after sleeve gastrectomy

Background: Pregnancy outcomes after bariatric surgery have been addressed extensively; however, the impact of pregnancy on long-term outcomes after bariatric surgery has only been sparsely studied. Objectives: We explored the effects of pregnancy on weight loss outcomes after laparoscopic sleeve gastrectomy (LSG). Setting: University hospital. Methods: A cross-sectional case-control study. Eighty women who became pregnant after LSG were matched by preoperative body mass index, age, and follow-up duration to 80 post-LSG patients who did not conceive after surgery (control group). Results: The median follow-up duration was 5.2 years for the study group and 5.3 years for the control group (P =.73). For the study group, the median time from surgery to conception was 508 (interquartile range 372–954) days and the median gestational weight gain was 9 (6–12) kg. Comparing the study with the control group, median percentage total weight loss was similar, 31% versus 30% (P =.77); as was percentage excess weight loss (EWL%) 72% versus 71% (P =.77). For the study group, a multivariable analysis showed EWL% at the end of follow-up to be directly correlated with the lowest EWL% achieved before pregnancy (β =.78, P <.0001), and inversely correlated with time lapsed from surgery (β = −.26, P <.0001); yet EWL% was not found to be associated with surgery-to-conception time interval, gestational weight gain, breastfeeding, co-morbidities, smoking, occupational status, physical activity, and dietary habits. Conclusions: Pregnancy after LSG does not affect long-term weight results. Coupled with the positive reports of improved pregnancy outcomes after bariatric surgery, these data should reassure women who wish to conceive after surgery.