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减肥手术后的妊娠结局:对母体、胎儿和婴儿的影响

Pregnancy outcomes after bariatric surgery: maternal, fetal, and infant implications.

作者信息

Abodeely Adam, Roye G Dean, Harrington David T, Cioffi William G

机构信息

Department of Surgery, Brown Medical School, Rhode Island Hospital, Providence, RI, USA.

出版信息

Surg Obes Relat Dis. 2008 May-Jun;4(3):464-71. doi: 10.1016/j.soard.2007.08.018. Epub 2007 Nov 5.

Abstract

Obese women who become pregnant face many health risks, including gestational diabetes, pregnancy-induced hypertension, and pre-eclampsia. These women also have a greater incidence of preterm labor, cesarean sections, and perioperative morbidity. Infants born to obese women have increased rates of macrosomia and congenital anomalies, as well as life-long complications such as obesity and its associated morbidities. With the increase in numbers of weight loss operations being performed in women of child-bearing age, physicians will have to address patient concerns regarding the safety of pregnancy after surgery. Many of the proposed health benefits of weight loss after surgery could translate to decreased rates of complications experienced by obese pregnant women. Case reports and small series have emerged documenting pregnancy courses after bariatric surgery. We reviewed the studies that reported pregnancy outcomes compiled from PubMed and Ovid databases to help draw conclusions regarding the maternal, fetal, and infant safety in women after bariatric surgery. The observations from these studies have shown that the health risks experienced by obese women during pregnancy are reduced after weight loss surgery. Additionally, there does not appear to be any increased risk regarding fetal or infant outcome.

摘要

肥胖女性怀孕面临诸多健康风险,包括妊娠期糖尿病、妊娠高血压和先兆子痫。这些女性早产、剖宫产及围手术期发病率也更高。肥胖女性所生婴儿出现巨大儿和先天性畸形的几率增加,还有肥胖及其相关疾病等终身并发症。随着育龄期女性减肥手术数量的增加,医生将不得不解决患者对术后妊娠安全性的担忧。手术后减肥带来的许多预期健康益处可能会转化为肥胖孕妇并发症发生率的降低。已经出现了一些病例报告和小系列研究记录了减肥手术后的妊娠过程。我们回顾了从PubMed和Ovid数据库收集的报告妊娠结局的研究,以帮助得出关于减肥手术后女性的孕产妇、胎儿和婴儿安全性的结论。这些研究的观察结果表明,减肥手术后肥胖女性在孕期所经历的健康风险降低。此外,胎儿或婴儿结局似乎没有任何增加的风险。

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