{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:52:21Z","timestamp":1791413541954,"version":"4.3.3"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"10","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction Bariatric metabolic surgery (MBS) is increasingly performed\n                    in women of reproductive age. Although MBS reduces obesity-related pregnancy\n                    complications, altered metabolism and nutritional deficiencies may adversely\n                    affect maternal and neonatal outcomes. This study evaluated (1) adherence to\n                    current guideline recommendations and (2) pregnancy outcomes in women after MBS\n                    in Germany.<\/jats:p>\n                  <jats:p>Materials and Methods In this multicenter cohort study, 410 pregnancies\n                    after MBS were collected between 2023\u200a\u2013\u200a2025; 380 cases with complete data on\n                    BMI, MBS type, and birth weight were finally analyzed. Maternal characteristics,\n                    surgical details, preconceptional and prenatal care, and perinatal outcomes were\n                    descriptively assessed and compared with national reference data.<\/jats:p>\n                  <jats:p>Results Preconceptional BMI was 30.1\u2009kg\/m2, 52% of the women\n                    were obese. Most common procedures were Roux-en-Y gastric bypass (RYGB; 58%) and\n                    sleeve gastrectomy (38%). Overall, 16% of the women conceived &lt;\u20091 year after\n                    MBS, 27% after 1\u200a\u2013\u200a2 years, and 57% after &gt;\u20092 years. Before conception, 35%\n                    of the women neither received supplementation nor assessment for deficiencies\n                    (52%); similar rates were observed during pregnancy. Anemia occurred in 40%,\n                    particularly after RYGB. Oral glucose tolerance testing for gestational diabetes\n                    screening was used in 33% despite recommendations against it after MBS.\n                    Gestational diabetes was diagnosed in 23%. Rates of small and large for\n                    gestational age newborns were 20% and 6%, respectively; preterm birth occurred\n                    in 10% and C-section in 46%.<\/jats:p>\n                  <jats:p>Conclusions High rates of anemia and SGA highlight the need for\n                    specialized high-risk pregnancy care after MBS. Several guideline\n                    recommendations regarding surgery-to-conception interval, supplementation, and\n                    GDM screening were not consistently followed.<\/jats:p>","DOI":"10.1055\/a-2889-3406","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T22:48:20Z","timestamp":1783378100000},"page":"907-914","source":"Crossref","is-referenced-by-count":0,"title":["Insufficient Implementation of Recommendations in Pregnancies after\n                    Bariatric Surgery: Results from a Nationwide Real-World Study in Germany (PABS\n                    Study)"],"prefix":"10.1055","volume":"86","author":[{"given":"Ute Margaretha","family":"Schaefer-Graf","sequence":"additional","affiliation":[{"name":"Berlin Center for Diabetes & Pregnancy, Dept. Obstetrics and\n                    Gynecology, St.\u00a0Joseph Hospital, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryna","family":"Fauzan","sequence":"additional","affiliation":[{"name":"Berlin Center for Diabetes & Pregnancy, Dept. Obstetrics and\n                    Gynecology, St.\u00a0Joseph Hospital, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babett","family":"Ramsauer","sequence":"additional","affiliation":[{"name":"Clinic of Obstetric Medicine, Clinicum Vivantes Neukoelln, Berlin,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Morfeld","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine, DIAKOVERE Hannover,\n                    Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Groten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Jena University Hospital, Jena,\n                    Germany"},{"name":"Department of Obstetrics, University of Cologne, Faculty of Medicine\n                    and University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidrun","family":"Sagmeister","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Graz,\n                    Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Sanakliniken Duisburg,\n                    Duisburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-391X","authenticated-orcid":false,"given":"Friederike","family":"Weschenfelder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Jena University Hospital, Jena,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for all participating centers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1764","DOI":"10.1007\/s11695-024-07196-3","article-title":"Metabolic Bariatric Surgery Across the IFSO Chapters: Key Insights on the\n                    Baseline Patient Demographics, Procedure Types, and Mortality from the Eighth\n                    IFSO Global Registry Report","volume":"34","author":"W A Brown","year":"2024","journal-title":"Obes Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1056\/NEJMoa1405789","article-title":"Outcomes of pregnancy after bariatric surgery","volume":"372","author":"K Johansson","year":"2015","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/j.ajog.2018.02.003","article-title":"Maternal and neonatal outcomes after bariatric surgery; a systematic review and\n                    meta-analysis: do the benefits outweigh the risks?","volume":"218","author":"W Kwong","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"4542","DOI":"10.1007\/s11695-021-05546-z","article-title":"Micronutrient supplementation in pregnancies following bariatric surgery: a\n                    practical review for clinicians","volume":"31","author":"G Vanheule","year":"2021","journal-title":"Obes Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3608","DOI":"10.1007\/s11695-024-07446-4","article-title":"Nutrient Status and Supplement Use During Pregnancy Following Metabolic\n                    Bariatric Surgery: A Multicenter Observational Cohort Study","volume":"34","author":"L Heusschen","year":"2024","journal-title":"Obes Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.soard.2022.02.019","article-title":"Nutrition for pregnancy after metabolic and bariatric surgery: literature review\n                    and practical guide","volume":"18","author":"K Chapmon","year":"2022","journal-title":"Surg Obes Relat Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/AOG.0000000000005088","article-title":"Perinatal Outcomes After Bariatric Surgery Compared With a Matched Control\n                    Group","volume":"141","author":"M J Boller","year":"2023","journal-title":"Obstet Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"485.e1","DOI":"10.1016\/j.ajog.2024.08.044","article-title":"Pregnancy and offspring outcomes after prepregnancy bariatric surgery","volume":"232","author":"J Eccles-Smith","year":"2025","journal-title":"Am J Obstet Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"464.e1","DOI":"10.1016\/j.ajog.2013.02.046","article-title":"The risk of adverse pregnancy outcome after bariatric surgery: a nationwide\n                    register-based matched cohort study","volume":"208","author":"M M Kj\u00e6r","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1111\/obr.12927","article-title":"Pregnancy after bariatric surgery: Consensus recommendations for periconception,\n                    antenatal and postnatal care","volume":"20","author":"J Shawe","year":"2019","journal-title":"Obes Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"96","DOI":"10.5694\/mja2.51373","article-title":"Fertility, pregnancy and post partum management after bariatric surgery: a\n                    narrative review","volume":"216","author":"S Cheah","year":"2022","journal-title":"Med J Aust"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1055\/a-0706-7578","article-title":"Fertility, Pregnancy and Lactation After Bariatric Surgery \u2013 a Consensus\n                    Statement from the OEGGG","volume":"78","author":"T Stopp","year":"2018","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1055\/s-2006-924458","article-title":"Analysis of the neonatal collective in the Federal Republic of Germany 12th\n                    report. Presentation of detailed percentiles for the body measurement of\n                    newborns","volume":"66","author":"M Voigt","year":"2006","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.17226\/12584","volume-title":"Weight Gain During Pregnancy: Reexamining the Guidelines","author":"K M Rasmussen","year":"2009"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2072","DOI":"10.1007\/s11695-020-05219-3","article-title":"A Matter of Timing-Pregnancy After Bariatric Surgery","volume":"31","author":"L Heusschen","year":"2021","journal-title":"Obes Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"204","DOI":"10.3390\/jcm10020204","article-title":"A Prospective Study of Association of Micronutrients Deficiencies during\n                    Pregnancy and Neonatal Outcome among Women after Bariatric Surgery","volume":"10","author":"G Ducarme","year":"2021","journal-title":"J Clin Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"4415","DOI":"10.3390\/nu15204415","article-title":"Preconception and Pregnancy Nutrition Support for Women with a History of\n                    Bariatric Surgery: A Mixed-Methods Survey of Healthcare Professionals in the\n                    UK","volume":"15","author":"Z Akhter","year":"2023","journal-title":"Nutrients"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.3390\/nu16152516","article-title":"Gestational Weight Gain Following Metabolic Bariatric Surgery: A Scoping\n                    Review","volume":"16","author":"E Deleus","year":"2024","journal-title":"Nutrients"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1016\/j.soard.2018.09.485","article-title":"The effect of surgery-to-conception interval on pregnancy outcomes after sleeve\n                    gastrectomy","volume":"14","author":"A Rottenstreich","year":"2018","journal-title":"Surg Obes Relat Dis"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1007\/s11695-024-07147-y","article-title":"Pregnancy After Bariatric Surgery-Experience from a Tertiary Center","volume":"34","author":"H U Ferreira","year":"2024","journal-title":"Obes Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1007\/s11695-023-06496-4","article-title":"Gestational Weight Gain in Pregnancies Following Bariatric Surgery","volume":"33","author":"C Iacovou","year":"2023","journal-title":"Obes Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1590\/2359-3997000000149","article-title":"Adverse effects during the oral glucose tolerance test in post-bariatric surgery\n                    patients","volume":"60","author":"H F Andrade","year":"2016","journal-title":"Arch Endocrinol Metab"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e003642","DOI":"10.1136\/bmjdrc-2023-003642","article-title":"Increased glycemic variability in pregnant women with Roux-en-Y gastric bypass\n                    compared with sleeve gastrectomy","volume":"12","author":"K Alexiadou","year":"2024","journal-title":"BMJ Open Diabetes Res Care"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.3390\/nu10101479","article-title":"Screening and Management of Gestational Diabetes Mellitus after Bariatric\n                    Surgery","volume":"10","author":"K Benhalima","year":"2018","journal-title":"Nutrients"}],"container-title":["Geburtshilfe und Frauenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2889-3406.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:34:07Z","timestamp":1791412447000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2889-3406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":24,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,7]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2889-3406","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0016-5751","1438-8804"],"issn-type":[{"value":"0016-5751","type":"print"},{"value":"1438-8804","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}