Obstetric outcomes after restrictive bariatric surgery: what happens after 2 consecutive pregnancies?

Abstract

BACKGROUND:

The objective of this study was to compare the outcomes of 2 consecutive pregnancies of the same women who conceived after restrictive bariatric surgeries.

METHODS:

A retrospective study comparing consecutive pregnancy outcomes of the same women, who conceived before and twice after a restrictive bariatric surgery, was conducted.

RESULTS:

This study included 109 women, and therefore, 327 paired pregnancies: 109 pregnancies preceded and 218 followed restrictive bariatric surgery (87% had laparoscopic banding, and 13% had silastic ring vertical gastroplasty). Both prepregnancy and predelivery body mass index were significantly lower after bariatric surgery (36.7±4.4 versus 31. 5±5.5, P<.001; 40.6±5.5 versus 35.3±6.1, P<.001; respectively). This effect was preserved at the subsequent pregnancy (31.5±5.5 versus 31.3±6.3, P = .609, and 35.3±6.1 versus 35.1±5.9, P = .706, respectively). The rates of hypertensive disorders and gestational diabetes mellitus were significantly lower after the bariatric operation, for the first and the second pregnancy (21% versus 7.4% and 4.7%, P = .009, and 19% versus 5.6% and. 6.6%, P = .007, respectively). The rate of macrosomic newborn was significant lower in the second postbariatric pregnancy (11.1% before versus 1.1% after second pregnancy, P = .02). Using multiple logistic regression models controlling for maternal age, prepregnancy body mass index, and the type of surgery, the reduction in hypertensive disorders (adjusted odds ratio (OR) .3, 95% confidence interval (CI) .12-.82; P = .018 for the first postoperative pregnancy and adjusted OR .2, 95% CI .06-.64; P = .007 for the second postoperative pregnancy), and gestational diabetes mellitus (adjusted OR .2, 95% CI .06-.48; P = .001 for the first postoperative pregnancy and adjusted OR .3, 95% CI .05-.51; P = .002 for the second postoperative pregnancy) remained significant.

CONCLUSIONS:

A significant decrease in pregnancy complications, such as hypertensive disorders and gestational diabetes mellitus, is achieved after a restrictive bariatric surgery. This improvement is maintained at the second subsequent pregnancy.

• Authors: Doron Amsalem, Barak Aricha-Tamir, Issac Levi, Daniel Shai, Eyal Sheiner
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2014 May-Jun Vol. 10 Issue 3 Pg. 445-9 ISSN: 1878-7533 [Electronic] United States
• PMID: 24342035 (Publication Type: Journal Article)
• Copyright: © 2013 American Society for Bariatric Surgery Published by American Society for Metabolic and Bariatric Surgery All rights reserved.

Topics

• Adult
• Bariatric Surgery (methods)
• Body Mass Index
• Delivery, Obstetric (trends)
• Female
• Follow-Up Studies
• Humans
• Infant, Newborn
• Israel (epidemiology)
• Laparoscopy (methods)
• Male
• Obesity, Morbid (surgery)
• Odds Ratio
• Postoperative Period
• Pregnancy
• Pregnancy Complications (epidemiology)
• Pregnancy Outcome (epidemiology)
• Retrospective Studies
• Risk Factors
• Time Factors