Micronutrient supplementation in pregnancy after bariatric surgery: a narrative review

Abstract

Abstract Objectives: bariatric surgery has significantly modified the obstetric profile of women of reproductive age, reducing complications associated with severe obesity while introducing a distinct set of risks related to micronutrient absorption and metabolism. Pregnancy in this context occurs in an anatomically and physiologically altered organism, in which the increased nutritional demands of gestation overlap with persistent absorptive limitations. Methods: narrative review aims to synthesize current evidence on micronutrient deficiencies in pregnancy after bariatric surgery and to discuss practical strategies for supplementation and monitoring during prenatal care. Searches were conducted in the MEDLINE, LILACS, and SciELO databases from August to December 2025, using descriptors and free-text terms combined with Boolean operators. This review followed the recommendations of the Scale for the Quality Assessment of Narrative Review Articles (SANRA). Results: Scientific studies show a consistent pattern of increased risk for deficiencies of iron, folate, vitamin B12, thiamine, vitamin D, calcium, and trace elements, with potentially severe maternal and perinatal consequences. International guidelines and consensus statements converge in recommending more robust supplementation than that used in conventional prenatal care, systematic laboratorial monitoring, and timely use of sublingual or parenteral routes according to the clinical context. Although the evidence base is predominantly observational, its consistency points to the relevance of a preventive, structured, and multiprofessional approach. Conclusion: the organization of nutritional care, including supplementation strategies, monitoring, and therapeutic escalation emerges as a relevant component of maternal and fetal safety in pregnancy after bariatric surgery.