Patel Jitesh A, Patel Nilesh A, Thomas Ronald L, Nelms Justin K, Colella Joseph J
Department of Surgery, Division of Bariatric Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Surg Obes Relat Dis. 2008 Jan-Feb;4(1):39-45. doi: 10.1016/j.soard.2007.10.008.
Early reports described adverse perinatal outcomes of pregnancies after weight loss surgery (WLS), which subsequently raised concerns regarding safety. Our objective was to investigate, in a community-based, academic, tertiary care center, the safety of pregnancies after laparoscopic Roux-en-Y gastric bypass (LRYGB) and its potential effect on obesity-related perinatal complications.
The pregnancy outcomes of patients delivering infants after LRYGB at our institution were compared with those of control subjects (stratified by body mass index) who had not undergone WLS. The charts were retrospectively reviewed for demographics, delivery route, and perinatal complications.
A total of 26 patients who delivered after LRYGB and 254 controls were identified. The mean interval from LRYGB to conception was 25.4 +/- 13.0 months. In general, the perinatal complications in the LRYGB patients were similar to those in the nonobese controls and lower than in the obese and severe obese controls, although statistical significance was not noted for all complications. No spontaneous abortions or stillbirths occurred in the LRYGB patients. No LRYGB patients required intravenous nutrition or hydration. The overall incidence of cesarean section in the LRYGB patients was similar to that in the obese and severely obese controls but significantly greater than that in the nonobese controls. The complication rates were similar in pregnancies occurring "early" (<12 mo) versus "late" (>18 mo) after LRYGB.
The results of our study have shown that pregnancy after LRYGB is safe, with an incidence of perinatal complications similar to that of nonobese patients, and lower than that of obese and severely obese patients, who had not undergone WLS. Larger studies are required to demonstrate statistically significant improvements in outcome in patients treated with WLS.
早期报告描述了减肥手术后妊娠的不良围产期结局，这随后引发了对安全性的担忧。我们的目的是在一个基于社区的学术三级医疗中心，调查腹腔镜Roux-en-Y胃旁路术（LRYGB）后妊娠的安全性及其对肥胖相关围产期并发症的潜在影响。
将在我们机构接受LRYGB手术后分娩婴儿的患者的妊娠结局与未接受减肥手术的对照受试者（按体重指数分层）的结局进行比较。回顾病历以获取人口统计学、分娩方式和围产期并发症信息。
共确定了26例LRYGB术后分娩的患者和254例对照。从LRYGB到受孕的平均间隔为25.4±13.0个月。总体而言，LRYGB患者的围产期并发症与非肥胖对照相似，低于肥胖和重度肥胖对照，尽管并非所有并发症都具有统计学意义。LRYGB患者未发生自然流产或死产。没有LRYGB患者需要静脉营养或补液。LRYGB患者剖宫产的总体发生率与肥胖和重度肥胖对照相似，但显著高于非肥胖对照。LRYGB术后“早期”（<12个月）与“晚期”（>18个月）妊娠的并发症发生率相似。
我们的研究结果表明，LRYGB术后妊娠是安全的，围产期并发症发生率与非肥胖患者相似，低于未接受减肥手术的肥胖和重度肥胖患者。需要更大规模的研究来证明减肥手术治疗患者的结局有统计学意义的改善。
