Updates in Pregnancy in Individuals with Obesity and After Bariatric Surgery.

Michelle A Kominiarek, Mariana Espinal, Jacqueline C Hairston

Journal: Obstetrics and gynecology clinics of North America 2025;52(3):413-430

PMID: 40769654

Abstract

Obesity significantly impacts reproductive health, increasing risks for infertility, early pregnancy loss, gestational diabetes, hypertension, preterm birth, stillbirth, and delivery complications, such as cesarean delivery, surgical infections, and postpartum hemorrhage. Obesity raises the likelihood of congenital anomalies, while reducing the effectiveness of ultrasound for anomaly detection, and has long-term effects on offspring. Bariatric surgery can improve outcomes by reducing risks of gestational diabetes and macrosomia, but nutritional deficiencies and surgical complications require careful management, especially if pregnancy occurs soon after surgery. Anti-obesity medications also offer weight management benefits but pose safety concerns during pregnancy, necessitating contraception and careful pregnancy planning.

Copyright © 2025 Elsevier Inc. All rights reserved.

Address: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 East Superior Street, Suite 05-2303, Chicago, IL, USA.; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 East Superior Street, Suite 05-2303, Chicago, IL, USA. Electronic address: [email protected].
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