We thank Drs Galazis and Sein for their kind comments on our study. As they mention, our findings are consistent with the meta-analysis by Galazis et al showing that the incidence of small-for-gestational age (SGA) was increased in women who underwent bariatric surgery but not when adjustable gastric banding (a restrictive procedure) was performed. We do suggest that restrictive, rather than malabsorptive, procedures should be preferred in young women planning to have children. Gastric banding, however, is less effective than gastric bypass for weight loss and thus less popular, and it carries an increased risk of surgical complications during pregnancy. Today, sleeve gastrectomy seems to be a more promising restrictive procedure; however, large cohort studies on pregnancy outcomes after this operation are still lacking. Follow-up is required to improve counseling for the ever-increasing numbers of women of childbearing age who are considering bariatric surgery.
References
- 1. Galazis N, Sein E. Restrictive bariatric procedures improve pregnancy outcomes compared to malabsorptive procedures. Am J Obstet Gynecol [epub ahead of print].
- 2. Chevrot A, Kayem G, Coupaye M, Lesage N, Msika S, Mandelbrot L. Impact of bariatric surgery on fetal growth restriction: experience of a perinatal and bariatric surgery center. Am J Obstet Gynecol [epub ahead of print].
- 3. Galazis N., Docheva N., Simillis C., and Nicolaides K.H.: Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2014; 181: pp. 45-53
- 4. Chevrot A, Lesage N, Msika S, Mandelbrot L. Digestive surgical complications during pregnancy following bariatric surgery: experience of a center for perinatology and obesity [in French]. J Gynecol Obstet Biol Reprod (Paris) [epub ahead of print].