http://hdl.handle.net/10027/7628 Fri, 24 May 2013 07:49:21 GMT 2013-05-24T07:49:21Z http://hdl.handle.net/10027/8340 Preparing for and Managing a Pregnancy After Bariatric Surgery Kominiarek, Michelle A. The number of bariatric surgeries performed in the United States has risen exponentially. Given that the majority of patients are female and of reproductive age, it is important for clinicians who manage women’s health issues to be aware of the surgery, its long term goals, and the potential effect on future pregnancies. Most pregnancies after bariatric surgery have successful outcomes with decreased occurrences of gestational diabetes and hypertension and lower birth weight compared with controls. Adherence to nutritional guidelines and supplementation in the event of deficiencies are critical in the provision of prenatal care to this unique population. Other important issues include a multidisciplinary team management, a different approach to screening for gestational diabetes, careful evaluation of any gastrointestinal complaints, and appropriate counseling for gravidas who still remain obese during pregnancy. Further research should investigate the long-term maternal outcomes in pregnancies after bariatric surgery as well as the effect on the offspring. NOTICE: this is the author’s version of a work that was accepted for publication in Seminars in Perinatology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Seminars in Perinatology, Vol 35, Issue 6, Dec 2011. DOI: 10.1053/j.semperi.2011.05.022 Thu, 01 Dec 2011 06:00:00 GMT http://hdl.handle.net/10027/8340 2011-12-01T06:00:00Z http://hdl.handle.net/10027/7702 Maternal Obesity: Do Patients Understand the Risks? Kominiarek, Michelle A.; Vonderheid, Susan; Endres, Lorraine K. Objective: To evaluate patient knowledge of the risks of maternal obesity and compare knowledge between non-obese and obese women. Study Design: A face-to-face survey was administered to 105 women at their first prenatal visit. The survey assessed their knowledge of obesity-related risks during pregnancy, weight history and goals, and health behaviors. Descriptive statistics described the entire sample. Student’s t and Chi-square tests compared knowledge between non-obese (BMI<30kg/m2) and obese (BMI≥30kg/m2) gravidas. Results: There were 56(54%) non-obese and 47(46%) obese participants. There were no significant differences between the weight groups with respect to age, race, insurance, education, tobacco use, and primigravity. Overall, 49% participants knew that obesity increases risk in pregnancy. The knowledge of specific risks was similar in the non-obese (60% correct) and obese (64% correct) groups, p=0.76. Obese patients were more aware of the risk for diabetes, 68% vs. 96%, p<0.001. Obese gravidas expressed more interest in weight loss prior to another pregnancy (61% vs. 81%, p=0.03); though the desired BMI's (22.1±2.3 vs. 26.2±3.0 kg/m2, p<0.001) were different for nonobese and obese women, respectively. Of all participants, 9% discussed the risks of maternal obesity with a provider prior to study participation and 75% wanted to participate in a study on weight loss prior to pregnancy to determine whether it leads to healthier pregnancies. 3 Kominiarek Obesity Survey Conclusions: Regardless of BMI category, patients require more knowledge about the risks of obesity in pregnancy, requested additional information, and were motivated to lose weight before future pregnancies. Because obese women underestimated their optimal weight loss goals, it is necessary to target this group for further education. Post print version of article may differ from published version. The definitive version is available through Nature Publishing Group at DOI: 10.1038/jp.2010.52. Thu, 01 Jul 2010 05:00:00 GMT http://hdl.handle.net/10027/7702 2010-07-01T05:00:00Z