Test Can Predict Pregnancy Outcomes in Post-Bariatric Surgery Patients

Hypoglycemia during an oral glucose tolerance test can predict pregnancy outcomes in women who have undergone bariatric surgery and then get pregnant, according to a new review.

For their investigation, the researchers analyzed the medical records of 119 pregnant women who had undergone 3 types of bariatric surgery before getting pregnant: laparoscopic sleeve gastrectomy (n = 55), laparoscopic adjustable gastric banding (n = 34), and laparoscopic Roux-en-Y gastric bypass surgery (n = 30).

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Among the data included in the researchers’ analysis were the results of a 100-g, 3-hour oral glucose tolerance test as well as maternal and fetal outcomes. Hypoglycemia was defined as a blood sugar level below 55 mg/dL.

Overall, 59 women were found to have been hypoglycemic during their oral glucose tolerance test.

Women who had undergone Roux-en-Y gastric bypass surgery had a higher risk of hypoglycemia than those who had undergone laparoscopic sleeve gastrectomy or laparoscopic adjustable gastric banding (83.3% vs 54.5% vs 11.8%).

Women with evidence of hypoglycemia had a significantly shorter time from surgery to conception (711 days vs 1246 days) and had a lower rate of gestational diabetes. However, these women also experienced higher risk for giving birth to a neonate with low birth weight and having small for gestational age infants.

“Because hypoglycemia is common during [an oral glucose tolerance test] among post-[bariatric surgery] parturients, other diagnostic methods should be considered in this setting,” the researchers concluded. “The association found between hypoglycemia and poor fetal growth warrants investigation as to whether interventions to prevent hypoglycemia will improve fetal outcome.”

—Amanda Balbi

Reference:

Rottenstreich A, Elazary R, Ezra Y, Kleinstern G, Beglaibter N, Elchalal U. Hypoglycemia during oral glucose tolerance test among post-bariatric surgery pregnant patients: incidence and perinatal significance. 2018;14(3):347-353. https://doi.org/10.1016/j.soard.2017.11.031.