Folic acid deficiency in post-bariatric pregnant women: a systematic review

Introduction: Bariatric surgery is the most effective treatment for obesity. However, energy restriction and nutrient malabsorption increase the risk of nutritional deficiencies. In post-bariatric surgery pregnant women, folic acid deficiency can cause complications for the mother and fetus. Objective: To evaluate folic acid deficiency in pregnant women who underwent bariatric surgery, through a systematic literature review. Matarals and methods: From the PubMed database, original observational articles were included, without language restriction and year of publication, that reported the levels of folic acid or the prevalence of its deficiency in pregnant women who underwent bariatric surgery, without restriction of surgical technique. Results: From an initial search conducted in the PUBMED database, 29 articles were identified that were compatible with the chosen theme. After applying the eligibility criteria, 5 articles were included to be analyzed in this study. The levels of folic acid in most studies remained adequate and may be associated with the use of multivitamin supplements in some studies even combined with folic acid supplementation. Discussion: It is possible the association with the use of supplements during pregnancy in women who underwent bariatric surgery, ensure an adequate vitamin supply, protecting the fetus from congenital anomalies and deficiencies in the neural tube, as well as ensuring good nutrition for the pregnant woman. Conclusion: From this systematic review it was possible to identify the low prevalence of folic acid deficiency, as well as average serum levels according to reference values for folic acid.