Obesidad y embarazo

Embarazo después de cirugía bariátrica: una revisión Pregnancy after Bariatric Surgery: A Review N. L. Hezelgrave and Eugene Oteng-Ntim Maternal and Fetal Research Unit, Kings College London, St. Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK Journal of Obesity Volume 2011 (2011), Article ID 501939, 5 pages doi:10.1155/2011/501939 Maternal obesity is a major cause of obstetric morbidity and mortality. With surgical procedures to facilitate weight loss becoming more widely available and demanded and increasing number of women becoming pregnant after undergoing bariatric surgery, it is important and timely to consider the outcome of pregnancy following bariatric surgery. This paper aims to synthesize the current evidence regarding pregnancy outcomes after bariatric surgery. It concludes that bariatric surgery appears to have positive effects on fertility and reduces the risk of gestational diabetes and preeclampsia. Moreover, there appears to be a reduced incidence of fetal macrosomia post-bariatric procedure, although there remains uncertainty about the increased rates of small-for-gestational age and intrauterine growth restricted infants, as well as premature rupture of membranes in this group. A number of case reports highlight that pregnancy following bariatric surgery is not without complications and it must be managed as high risk by the multidisciplinary team http://www.hindawi.com/journals/jobes/2011/501939/   La asociación entre el aumento de peso durante el embarazo y el peso al nacer: una comparación dentro de la familia The association between pregnancy weight gain and birthweight: a within-family comparison David S Ludwig, Janet Currie Lancet 2010; 376: 984-90 Summary Background Excessive weight gain during pregnancy seems to increase birthweight and the off spring's risk of obesity later in life. However, this association might be confounded by genetic and other shared effects. We aimed to examine the association between maternal weight gain and birthweight using state-based birth registry data that allowed us to compare several pregnancies in the same mother. Methods In this population-based cohort study, we used vital statistics natality records to examine all known births in Michigan and New Jersey, USA, between Jan 1, 1989, and Dec 31, 2003. From an initial sample of women with more than one singleton birth in the database, we made the following exclusions: gestation less than 37 weeks or 41 weeks or more; maternal diabetes; birthweight less than 500 g or more than 7000 g; and missing data for pregnancy weight gain. We examined how diff erences in weight gain that occurred during two or more pregnancies for each woman predicted the birthweight of her off spring, using a within-subject design to reduce confounding to a minimum. Findings Our analysis included 513 501 women and their 1 164 750 off spring. We noted a consistent association between pregnancy weight gain and birthweight (β 7・35, 95% CI 7・10-7・59, p<0・0001). Infants of women who gained more than 24 kg during pregnancy were 148・9 g (141・7-156・0) heavier at birth than were infants of women who gained 8-10 kg. The odds ratio of giving birth to an infant weighing more than 4000 g was 2・26 (2・09-2・44) for women who gained more than 24 kg during pregnancy compared with women who gained 8-10 kg. Interpretation Maternal weight gain during pregnancy increases birthweight independently of genetic factors. In view of the apparent association between birthweight  http://mail.elsevier-alerts.com/AEM/Clients/ELA001/collex_articles/obs_association.pdf

Atentamente Dr. Benito Cortes-Blanco Anestesiología y Medicina del Dolor www.anestesia-dolor.org