Bariatric surgery after childbirth: does a history of pregnancy affect weight loss after surgery? The Maternal Outcomes of Bariatric Surgery and Pregnancy Study (MOMBARIS).

INTRODUCTION

Obesity is a major global health issue associated with comorbidities, such as type 2 diabetes mellitus (T2DM) and cardiovascular disease. Bariatric surgery is effective, but its outcomes vary. Obstetric history may influence results, as pregnancy induces lasting metabolic and hormonal changes, though current evidence remains unclear.

AIM: This study aimed to evaluate whether preoperative pregnancy history affects weight loss outcomes after bariatric surgery.

MATERIALS AND

METHODS

A retrospective multicenter analysis was conducted within the Maternal Outcomes of Bariatric Surgery and Pregnancy Study project, including 1399 women from 11 Polish bariatric centers. The participants were divided into 2 groups: women with a history of pregnancy (n=1061) and nulliparous women (n=338). Primary outcomes included percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and overall weight reduction.

RESULTS

Women with prior childbirth were older (42 vs 32.5 y; P <⁠0.001) and more frequently had T2DM (22% vs 12%; P <⁠0.001) and hypertension (44.9% vs 23.4%; P <⁠0.001) than the nulliparous participants. Median postoperative body mass index (BMI) was similar in both groups (29 kg/m²), but weight loss differed considerably. Women with childbirth history achieved lower %TWL (28.57% vs 33.85%; P <⁠0.001) and %EWL (72.17% vs 78.44%; P =0.001), as compared with those who never gave birth. Multivariate regression identified age, preoperative BMI, hypertension, and dyslipidemia as independent factors affecting weight loss.

CONCLUSIONS

Women with a history of childbirth achieve poorer weight loss outcomes after bariatric surgery; however, it is not an independent factor influencing bariatric results.