Endocrine Abstracts

JOINT203

Background and aims: Overweight and obese women have an increased risk of spontaneous miscarriage as Type 2 (T2DM) diabetes mellitus is associated with increased rates of adverse maternal and neonatal outcomes. Adverse outcomes are more common in women with pregestational diabetes compared to GDM. Obesity, with its associated metabolic and endocrine aberrations, can directly influence the reproductive health of women. Bariatric surgery, which is primarily designed to induce significant weight loss, has been shown to have a positive impact on fertility outcomes

Methods: The patient was diagnosed with type 2 diabetes at the age of 29. At the age of 33, she gave birth to a dead fetus in the 7th month of pregnancy with fetal hydrocephalus. At that time BMI -50kg/m². The second pregnancy at the age of 38 ended with spontaneous abortion at 7 weeks. BMI -52.1 kg/m². Insulin therapy was used during both pregnancies. Diabetes mellitus was controlled before and after pregnancy. Bariatric surgery was performed at the age of 40. BMI -53.3 kg/m². After 4 years BMI -33.3kg/m². Secondary infertility was established. Pregnancy with twin fetuses occurred through in vitro fertilization. Diabetes was managed with insulin. 2 healthy newborns were born by cesarean section at 34 weeks of pregnancy

Results: Significant weight loss in obese T2DM patients after bariatric surgery was associated with a substantial reduction in BMI from 53.3.5 kg/m² to - 33.3 kg/m². Gradual weight loss has been shown to improve fertility and outcomes of fertility treatments and reduce cardiovascular and diabetes-associated morbidity and mortality

Conclusion: Women should be advised pre-pregnancy about the impact of being obese and risk of early pregnancy complications. Epidemiological evidence suggests an increased risk of both spontaneous and recurrent pregnancy loss with obesity. The ESHRE guidance recommends that couples with obesity and previous repeated pregnancy loss achieve a normal range BMI (20–25 kg/m² for White individuals) before conceiving. A normal BMI can be associated with multiple health benefits for both mother and baby.