Impact of bariatric surgery on reproductive health in women with obesity

The issue of obesity remains highly relevant both in Russia and worldwide, becoming increasingly acute each year. Bariatric surgery in women with obesity is associated with a number of positive effects, including improved fertility, a reduced risk of gestational diabetes and pre-eclampsia due to enhanced insulin sensitivity and normalization of glucose levels. However, the intrapartum and postpartum periods are associated with several challenges, including an increased risk of micronutrient deficiencies, development of dumping syndrome, anemia, and fetal growth retardation. Therefore, it is essential to develop individualized treatment plans for patients following bariatric surgery to prevent potential complications affecting both the mother and the fetus. Special attention should be paid to additional vitamin intake and individualized dietary planning, as these are important for the future child's health. Bariatric surgery is an effective treatment for obesity, but it should only be recommended when conservative approaches—such as dietary and lifestyle modifications, pharmacotherapy, and increased physical activity—fail to achieve sufficient weight loss. When choosing this method of obesity treatment, women should be informed about possible complications, postoperative metabolic peculiarities, and the necessity of their correction. It is also important to inform patients about postoperative rehabilitation and preconception care, which should last 12–18 months after surgery before planning a pregnancy. This review was based on a search in the PubMed database using the logical operator and a combination of the following keywords: pregnancy and bariatric procedures. This search yielded 111 results, 50 of which were relevant to the study topic. The types of publications included: article type, books and documents, clinical trial, meta-analysis, randomized controlled trial, review, and systematic review. An additional publication search was conducted using the eLibrary and PubMed databases, focusing on the following keywords: ожирение и репродуктивная система (obesity and reproductive system), ожирение и бесплодие (obesity and infertility), бариатрическая хирургия (bariatric surgery), осложнения бариатрической операции (bariatric surgery complications), морбидное ожирение (morbid obesity), and беременность после бариатрической операции (pregnancy after bariatric surgery). The review includes articles published over the past 10 years.