Pregnancy

In a nutshell, you should do fine, but will require close work with your OB and bypass surgeon. You'll need to monitor your weight, nutrition, and vitamin levels including B12, and B1 very carefully. Good luck and much happiness.

Here are summaries of recent reports in the medical literature. You could copy and discuss these with your doctors.

J Perinatol. 2009 Sep;29(9):640-2.

Congenital B12 deficiency following maternal gastric bypass.

Celiker MY, Chawla A.

Division of Pediatric Hematology/Oncology, Department of Pediatrics, Stony Brook University Medical Center, Stony Brook, NY 11794, USA. mceliker@stonybrook.edu
Abstract

Here we present a case of severe B12 deficiency in an exclusively breastfed infant, born to a mother who had undergone gastric bypass 6 years earlier. At 4 months of age, the infant presented with pancytopenia and developmental delay. Our evaluation revealed physical and neurological developmental delay, pancytopenia with macrocytosis, with head imaging showing cortical and subcortical atrophy. Serum studies showed low B12, normal folate and iron. Treatment with parenteral B12 led to the resolution of the pancytopenia, steady weight gain and improved neurological status. The child is currently 16 months old with normal anthropometric and hematological parameters and normal B12 levels on a regular diet. Gross motor and speech developments are significantly delayed. This case illustrates that maternal B12 deficiency following gastric bypass surgery may lead to severe B12 deficiency with long-term neurological sequelae in their infants. Screening and prompt treatment of these deficiencies both during pregnancy and during infancy are important.

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Obes Surg. 2010 Aug 30. [Epub ahead of print]
Obstetrical and Neonatal Outcomes of Pregnancies following Gastric Bypass Surgery: A Retrospective Cohort Study in a French Referral Centre.

Santulli P, Mandelbrot L, Facchiano E, Dussaux C, Ceccaldi PF, Ledoux S, Msika S.

Department of Obstetrics and Gynaecology, Assistance Publique-H�pitaux de Paris, Louis Mourier Hospital, 178 rue des Renouillers, 92700, Colombes, France.
Abstract

BACKGROUND: The objective of this study was to analyze obstetrical and neonatal outcomes following Roux en Y Gastric Bypass procedures (RYGBP).

METHODS: A retrospective cohort study was conducted in a single French tertiary perinatal care and bariatric center. The study involved 24 pregnancies, following RYGBP (exposed group) and two different control groups (non-exposed groups). A body mass index (BMI)-matched control group included 120 pregnancies matched for age, parity, and pregnancy BMI. A normal BMI control group included 120 pregnancies with normal BMI (18.5-24.9 kg/m(2)), matched for age and parity. Hospital data were reviewed from all groups in the same 6-year period. Obstetrical and neonatal outcomes after RYGB were compared, separately, to the two different-matched control groups.

RESULTS: The median interval from RYGBP to conception was 26.6 (range: 3-74) months. Rates of perinatal complications did not differ significantly between the RYGBP group and normal BMI and BMI-matched controls groups. The rate of Cesarean section before labor was higher in the RYGBP patients than in the normal BMI control group (25% vs. 9.3% respectively, p = 0.04). Weight gain was lower in the RYGBP patients than normal BMI control group (5.8 kg vs. 13.2 kg respectively, p < 0.0001). Birthweight was also lower in the RYGBP group than those in normal BMI and BMI-matched controls groups (2,948.2 g vs. 3,368.2 g and 3,441.8 g, respectively, p < 0.0001).

CONCLUSIONS: RYGBP surgery was associated with reduced birthweight, suggesting a possible role of nutritional growth restriction in pregnancy.

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N Z Med J. 2009 Nov 20;122(1306):33-42.
Pregnancy following gastric bypass surgery: what is the expected course and outcome?

Sapre N, Munting K, Pandita A, Stubbs R.

Wakefield Gastroenterology Centre, Private Bag 7909, Wellington, New Zealand.
Abstract

AIM: To examine the course of pregnancy, labour, and the neonatal period in a group of women who have become pregnant following gastric bypass surgery for severe obesity.

METHODS: Women who had experienced pregnancy following gastric bypass surgery were identified by an initial questionnaire. A second questionnaire was sent to those identified by the first questionnaire, who were willing to provide details concerning such pregnancies.

RESULTS: Seventeen women experienced a total of 24 pregnancies and 25 live births. Five had experienced difficulties with conception or pregnancy prior to surgery. The average maternal weight gain was 6.13 kg. No major problems with fetal growth were observed. Babies were delivered at a mean gestational age of 37.5 weeks and with a mean birth weight of 3038 g. Six women reported a complication during pregnancy (25%) and five a complication in labour (20%). Two babies born to the same mother had congenital abnormalities attributable to a rare genetic disorder.

CONCLUSION: The course of pregnancy and labour appears normalised for severely obese women following gastric bypass surgery. The weight loss and marked reduction in food intake following gastric bypass surgery does not lead to growth or development problems for offspring. Careful monitoring of expectant mothers who have undergone gastric bypass surgery is nevertheless to be recommended.