Professor Makrina Savvidou

Iacovou C, Maric T, Bourke M, Patel D, Savvidou Met al., 2023, Gestational Weight Gain in Pregnancies Following Bariatric Surgery., Obes Surg, Vol: 33, Pages: 1004-1011

INTRODUCTION: To compare the gestational weight gain (GWG) between women with previous bariatric surgery and those without and investigate whether GWG correlates with birthweight (BW) or delivery of a small-for-gestational-age (SGA) neonate. MATERIALS AND METHODS: Prospective, longitudinal study, include 100 pregnant women with previous bariatric surgery and 100 without weight loss surgery, but with similar early-pregnancy body mass index (BMI). In a sub-study, 50 of the post-bariatric women were also matched to 50 women without surgery, but early-pregnancy BMI similar to the pre-surgery BMI of the post-bariatric ones. All women had their weight/BMI measured at 11-14 and 35-37 weeks of gestation, and the difference in maternal weight/BMI between the two time points was expressed as GWG/BMI gain. Associations between maternal GWG/BMI gain and birthweight (BW) were examined. RESULTS: Compared to no bariatric women with similar early-pregnancy BMI, post-bariatric women had similar GWG (p = 0.46), and the number of women with appropriate, insufficient, and excessive weight gain was comparable between groups (p = 0.76). However, post-bariatric women delivered smaller babies (p < 0.001), and GWG was not a significant predictor of BW or of delivering a SGA neonate. Compared to no bariatric women with similar pre-surgery BMI, post-bariatric ones had higher GWG (p < 0.01) but still delivered smaller neonates (p = 0.001). CONCLUSIONS: Post-bariatric women seem to have similar or greater GWG compared to women without surgery matched for early-pregnancy or pre-surgery BMI, respectively. Maternal GWG was not associated with BW or higher prevalence of SGA neonates seen in women with previous bariatric surgery.

• Abstract
• Author Web Link
• Cite

Patel D, Borrelli N, Patey O, Johnson M, DI Salvo G, Savvidou MDet al., 2023, Effect of bariatric surgery on maternal cardiovascular system., Ultrasound Obstet Gynecol, Vol: 61, Pages: 207-214

OBJECTIVE: Bariatric surgery is a successful treatment for sustainable weight loss and has been associated with improvement in cardiovascular function. Pregnancy after bariatric surgery is becoming increasingly common; however, little is known about the maternal cardiovascular system postsurgery. The aim of this study was to investigate maternal cardiovascular adaptation to pregnancy in women with previous bariatric surgery, compared with that in women with no history of weight-loss surgery and an early-pregnancy body mass index (BMI) similar to the presurgery BMI of the postbariatric women. METHODS: This was a prospective, observational, longitudinal study conducted from April 2018 to June 2020 including 30 pregnant women who had undergone bariatric surgery and 30 who had not, matched for presurgery BMI. Participants were seen at three timepoints during pregnancy: 12-14, 20-24 and 30-32 weeks' gestation. At all visits, maternal blood pressure (BP) was measured and cardiac geometry and function were assessed using two-dimensional (2D) transthoracic echocardiography. On a subset of patients (15 in each group), 2D speckle tracking was performed to assess global longitudinal and circumferential strain. Offline analysis was performed, and multilevel linear mixed-effects models were used for all comparisons. RESULTS: Compared with the no-surgery group, and across all trimesters, pregnant women with previous bariatric surgery had lower BP, heart rate and cardiac output and higher peripheral vascular resistance (P < 0.01 for all). Similarly, the postbariatric group demonstrated more favorable cardiac geometry and diastolic indices, including lower left ventricular mass, left atrial volume and relative wall thickness, together with higher E-wave/A-wave flow velocity across the mitral valve and higher mitral velocity (E') at the lateral and medial annulus on tissue Doppler imaging (P < 0.01 for all). There was no difference in ejectio

• Abstract
• Author Web Link
• Cite

Bourke M, Patel D, Rocca A, Maric T, Savvidou Met al., 2021, Effect of postbariatric maternal weight loss and surgery to conception interval on perinatal outcomes of nulliparous women, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 17, Pages: 1473-1479, ISSN: 1550-7289

• Author Web Link
• Cite
• Citations: 2

Maric T, Kanu C, Johnson MR, Savvidou MDet al., 2019, Maternal, neonatal insulin resistance and neonatal anthropometrics in pregnancies following bariatric surgery, METABOLISM-CLINICAL AND EXPERIMENTAL, Vol: 97, Pages: 25-31, ISSN: 0026-0495

• Author Web Link
• Cite
• Citations: 14