*2.12.2 Maternal and perinatal outcomes after LSG*

Obese women have increased rates of adverse obstetric outcomes that include gestational diabetes mellitus, gestational hypertension, preeclampsia, cesarean section delivery, and adverse neonatal outcomes including congenital malformations,

macrosomia, and stillbirths [46]. WL with LSG has better maternal and perinatal outcomes [47]. A retrospective study comparing women who had undergone LSG with matching controls found that the LSG group had lower rates of gestational DM (3.4% vs 17.6%, P = 0.001), large-for-gestational-age neonates (1.7% vs 19.3%, P = 0.001), and birth weight > 4000 grams (0.8% vs 7.6%, P = 0.02) [47]. Conversely, LSG was associated with higher proportions of small-for-gestational-age (SGA) neonates (14.3% vs 4.2%, P = 0.01) and low-birth-weight neonates (12.6% vs 4.2%, P = 0.03) [47]. Cesarean delivery rates were lower in the LSG group (10.1% vs 20.2%, P = 0.04) [47]. However, LSG patients also had higher risk of iron deficiency anemia requiring treatment with intravenous iron supplementation during pregnancy [47]. This suggests that although LSG improves pregnancy outcomes, however, pregnant women need close monitoring for nutritional deficiencies post LSG.
