Sheiner Eyal, Balaban Evgenia, Dreiher Jacob, Levi Isaac, Levy Amalia
Departments of Obstetrics and Gynecology, Soroka University Medical Center, Faculty Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva, Israel.
Obes Surg. 2009 Sep;19(9):1286-92. doi: 10.1007/s11695-009-9920-9. Epub 2009 Jul 18.
The objective of this study was to investigate pregnancy outcome of patients following different types of bariatric surgery.
A population-based study includes all pregnancies of patients with bariatric surgeries delivered during 1988-2008. Pregnancy outcome was compared between the different types of surgeries.
This retrospective study included 449 deliveries: 394 deliveries following pure restrictive operations-laparoscopic gastric banding (LAGB; n = 202), silastic ring vertical gastroplasty (SRVG; n = 136), and vertical-banded gastroplasty (VBG; n = 56)-and 55 deliveries following restrictive and malabsorptive Roux-en-Y gastric bypass (RGB). While no significant differences were noted between the groups regarding body mass index (BMI) before the bariatric operations or prepregnancy BMI, patients following LAGB had significantly higher BMI before delivery (36.8 +/- 5.9 kg compared to the SRVG 33.4 +/- 6.0, VBG 34.2 +/- 5.4, and RGB 34.9 +/- 6.8 groups; p < 0.001). Following LAGB, patients had higher weight gain during pregnancy (13.1 +/- 9.6 kg) compared to the SRVG (8.8 +/- 7.4), VBG (8.5 +/- 8.0), and RGB (11.6 +/- 9.6; p < 0.001) groups. The interval between operation and pregnancy was shorter in the LAGB group (22.8 months) compared to the SRVG (41.0) and the VBG (42.1) groups and was significantly higher in the RGB group (57.4; p < 0.001). Birth weight was significantly higher among newborns of patients following RBG (3,332.8 +/- 475.5 g) compared to the restrictive procedures (3,104.3 +/- 578.7 in the LAGB, 3,086.7 +/- 533.1 in the SRVG, and 3,199.2 +/- 427.2 in the VBG groups). No significant differences in low birth weight (<2,500 g) or macrosomia (>4,000 g), or low Apgar scores or perinatal mortality were noted between the groups.
There is no difference in the affect on pregnancy outcome among the different forms of bariatric surgeries; all procedures have basically comparable perinatal outcome.
本研究的目的是调查不同类型减肥手术后患者的妊娠结局。
一项基于人群的研究纳入了1988年至2008年期间接受减肥手术的患者的所有妊娠情况。比较了不同类型手术之间的妊娠结局。
这项回顾性研究包括449例分娩：394例为单纯限制性手术（腹腔镜胃束带术[LAGB]；n = 202）、硅橡胶环垂直胃成形术（SRVG；n = 136）和垂直束带胃成形术（VBG；n = 56）后的分娩，以及55例限制性和吸收不良性 Roux-en-Y 胃旁路术（RGB）后的分娩。虽然在减肥手术前的体重指数（BMI）或孕前BMI方面，各组之间未观察到显著差异，但LAGB术后患者在分娩前的BMI显著更高（36.8±5.9kg，而SRVG组为33.4±6.0，VBG组为34.2±5.4，RGB组为34.9±6.8；p<0.001）。与SRVG组（8.8±7.4）、VBG组（8.5±8.0）和RGB组（11.6±9.6；p<0.001）相比，LAGB术后患者在孕期体重增加更多（13.1±9.6kg）。LAGB组手术与妊娠之间的间隔时间（22.8个月）比SRVG组（41.0个月）和VBG组（42.1个月）短，而RGB组显著更长（57.4个月；p<0.001）。RGB术后患者的新生儿出生体重（3332.8±475.5g）显著高于限制性手术组（LAGB组为3104.3±578.7g，SRVG组为3086.7±533.1g，VBG组为3199.2±427.2g）。各组之间在低出生体重（<2500g）或巨大儿（>4000g）、低Apgar评分或围产期死亡率方面未观察到显著差异。
不同形式的减肥手术对妊娠结局的影响没有差异；所有手术的围产期结局基本相当。
