{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:25:40Z","timestamp":1783419940070,"version":"3.54.6"},"reference-count":23,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Newcastle University Research Excellence Academy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Preconception bariatric surgery improves obesity-related maternal pregnancy complications but may reduce the absorption of nutrients required for healthy fetal growth and development. Women who receive preconception nutritional support after bariatric surgery are less likely to have adverse pregnancy outcomes. This study aimed to investigate the provision of preconception and pregnancy-specific nutritional support for women having bariatric surgery in the UK. A mixed-methods survey was distributed to healthcare professionals working in obesity or maternity services between December 2018 and October 2019. We collected both quantitative and qualitative data which were analysed using a mixed-methods approach. We received 135 responses from online (n = 99) and postal (n = 36) questionnaires. Only 45% of participants reported being \u2018very familiar\u2019 with the preconception\/pregnancy nutritional needs of this population. Barriers to providing nutritional support included: a lack of resources and time; poor communication both across services and with women; not having contact with women preconception; and a lack of information and guidance. Respondents felt that dietitians have the expertise in nutrition necessary to provide support; however, GPs and midwives have the most frequent patient access post-surgery, both before and during pregnancy. Optimal preconception and pregnancy-related nutritional support requires multidisciplinary care pre- and post-surgery, and healthcare professionals require training and guidance to inform practice.<\/jats:p>","DOI":"10.3390\/nu15204415","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T09:56:57Z","timestamp":1697623017000},"page":"4415","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preconception and Pregnancy Nutrition Support for Women with a History of Bariatric Surgery: A Mixed-Methods Survey of Healthcare Professionals in the UK"],"prefix":"10.3390","volume":"15","author":[{"given":"Zainab","family":"Akhter","sequence":"first","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Rankin","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Shackford-Alizart","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Ackroyd","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sheffield Teaching Hospitals, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-4684","authenticated-orcid":false,"given":"Roland","family":"Devlieger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8656-2319","authenticated-orcid":false,"given":"Nicola","family":"Heslehurst","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","unstructured":"Small, P., Mahawar, K., Walton, P., and Kinsman, R. (2020). 3rd Registry Report of the United Kingdom National Bariatric Surgery Registry, Dendrite Clinical Systems Ltd."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1007\/s11695-018-3593-1","article-title":"Bariatric Surgery Worldwide: Baseline Demographic Description and One-Year Outcomes from the Fourth IFSO Global Registry Report 2018","volume":"29","author":"Welbourn","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.ajog.2018.02.003","article-title":"Maternal and neonatal outcomes after bariatric surgery; a systematic review and meta-analysis: Do the benefits outweigh the risks?","volume":"218","author":"Kwong","year":"2018","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1001\/jama.2008.641","article-title":"Pregnancy and fertility following bariatric surgery: A systematic review","volume":"300","author":"Maggard","year":"2008","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/j.soard.2017.03.017","article-title":"Risk of low birth weight and micronutrient deficiencies in neonates from mothers after gastric bypass: A case control study","volume":"13","author":"Gascoin","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13087","DOI":"10.1111\/obr.13087","article-title":"British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery-2020 update","volume":"21","author":"Parretti","year":"2020","journal-title":"Obes. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Akhter, Z., Rankin, J., Ceulemans, D., Ngongalah, L., Ackroyd, R., Devlieger, R., Vieira, R., and Heslehurst, N. (2019). Pregnancy after bariatric surgery and adverse perinatal outcomes: A systematic review and meta-analysis. PLoS Med., 16.","DOI":"10.1371\/journal.pmed.1002866"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1007\/s11695-012-0675-3","article-title":"Lifestyle after bariatric surgery: A multicenter, prospective cohort study in pregnant women","volume":"22","author":"Guelinckx","year":"2012","journal-title":"Obes. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Akhter, Z., Heslehurst, N., Ceulemans, D., Rankin, J., Ackroyd, R., and Devlieger, R. (2021). Pregnancy after Bariatric Surgery: A Nested Case-Control Study of Risk Factors for Small for Gestational Age Babies in AURORA. Nutrients, 13.","DOI":"10.3390\/nu13051699"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s11695-015-1998-7","article-title":"Incidence of Successful Pregnancy After Weight Loss Interventions in Infertile Women: A Systematic Review and Meta-Analysis of the Literature","volume":"26","author":"Milone","year":"2016","journal-title":"Obes. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1136\/jfprhc-2014-100959","article-title":"Contraceptive needs of women following bariatric surgery","volume":"40","author":"Graham","year":"2014","journal-title":"J. Fam. Plan. Reprod. Health Care"},{"key":"ref_12","unstructured":"(2021, May 04). Obesity: Identification, Assessment and Management, Available online: https:\/\/www.nice.org.uk\/guidance\/cg189\/."},{"key":"ref_13","unstructured":"National Institute for Health and Care Excellence (2019). Appendix C-Women requiring additional care [NICE guideline CG62], Antenatal Care for Uncomplicated Pregnancies."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1111\/1471-0528.15386","article-title":"Care of Women with Obesity in Pregnancy","volume":"126","author":"Denison","year":"2019","journal-title":"BJOG"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1111\/obr.12927","article-title":"Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care","volume":"20","author":"Shawe","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_16","first-page":"119","article-title":"Designing pre-bariatric surgery education: The value of Patients\u2019 experiences","volume":"21","author":"Owers","year":"2017","journal-title":"J. Diabetes Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/intqhc\/mzg031","article-title":"Good practice in the conduct and reporting of survey research","volume":"15","author":"Kelley","year":"2003","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jclinepi.2004.06.004","article-title":"In a mailed physician survey, questionnaire length had a threshold effect on response rate","volume":"58","author":"Jepson","year":"2005","journal-title":"J. Clin. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gale, N.K., Heath, G., Cameron, E., Rashid, S., and Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med. Res. Methodol., 13.","DOI":"10.1186\/1471-2288-13-117"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1007\/s11695-015-2037-4","article-title":"A Survey of Bariatric Surgical and Reproductive Health Professionals\u2019 Knowledge and Provision of Contraception to Reproductive-Aged Bariatric Surgical Patients","volume":"26","author":"Graham","year":"2016","journal-title":"Obes. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S171","DOI":"10.1016\/j.ajog.2020.12.281","article-title":"259 Telephonic nutritional management program is associated with improved outcomes in pregnancy post-bariatric surgery","volume":"224","author":"Boller","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"American College of Obstretricians and Gynecologists (2009). ACOG practice bulletin no. 105: Bariatric surgery and pregnancy. Obs. Gynecol., 113, 1405\u20131413.","DOI":"10.1097\/AOG.0b013e3181ac0544"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1007\/s11695-017-2661-2","article-title":"Pregnancy After Bariatric Surgery: National Survey of Obstetrician\u2019s Comfort, Knowledge, and Practice Patterns","volume":"27","author":"Smid","year":"2017","journal-title":"Obes. 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