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Obesity surgery lowers diabetes risk in pregnancy

Severely obese women who undergo weight-loss surgery have a lower risk of developing diabetes during future pregnancies.

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Severely obese women who undergo weight-loss surgery have a lower risk of developing diabetes during future pregnancies.

While gestational diabetes usually resolves after childbirth, during pregnancy it may cause the fetus to grow abnormally large, which can make a C-section or forceps necessary and raise the risk of postpartum bleeding. Women who develop gestational diabetes also have a higher risk of developing type 2 diabetes later in life.

Researchers reviewed insurance records of 23,594 American women who had undergone obesity surgery between 2002 and 2006. Of those women, 346 had given birth during that same time period, but before having the surgery; another 354 had given birth after the surgery - typically about 20 months later.

Most had undergone gastric bypass, in which the upper portion of the stomach is stapled off to create a small pouch that restricts the amount of food a person can eat at one time. The surgeon also creates a bypass around the rest of the stomach and a portion of the small intestine, which limits the body's absorption of food. A minority - 42 women overall - had undergone gastric banding, where an adjustable band is used to create the pouch at the upper part of the stomach.

It was found that among women who had delivered before weight-loss surgery, 27 percent developed gestational diabetes during the pregnancy. That compared with eight percent of those who had delivered after their surgery. Similarly, the rate of C-section was lower in the latter group: 28 percent versus 43 percent. The researchers then factored in two other variables: the women's age and whether they had ever had a C-section in the past, which raises the odds of having one in subsequent pregnancies. With those factors considered, obesity surgery was linked to a 77 percent reduction in the risk of gestational diabetes and a 52 percent decrease in the odds of C-section.

The findings add to a growing body of evidence in favour of a protective effect of weight-loss surgery against gestational diabetes and C-section.

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