Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
J Womens Health (Larchmt). 2011 Sep;20(9):1363-6. doi: 10.1089/jwh.2010.2714. Epub 2011 Jul 12.
To compare pregnancy outcomes postbariatric surgery for women who remain obese at conception to those who were not obese.
From a database of women who received outpatient perinatal services, we identified women with a history of bariatric surgery who are currently pregnant with a singleton gestation. Available maternal characteristics and pregnancy outcomes were compared between women whose prepregnancy body mass index (PPBMI) remained in the obese range (≥30 kg/m(2)) and those with a PPBMI of <30 kg/m(2) using Fisher exact test, independent Student's t test, and Mann-Whitney U test statistics.
Of the 102 women identified, 52 (51%) were obese and 50 (49%) were not obese at conception. No differences were observed in maternal age, marital status, years from surgery to delivery, development of gestational diabetes, gestational age at delivery, neonatal intensive care unit (NICU) admission, or nursery days. Maternal obesity (≥30 kg/m(2)) postbariatric surgery was associated with higher rates of cesarean delivery (63.5% vs. 36.0%, p=0.010) and development of pregnancy-related hypertension (36.5% vs. 8.0%, p=0.001) compared to nonobese women (<30 kg/m(2)).
Postbariatric surgery, an optimal goal should be to achieve a nonobese weight status before conception to reduce maternal complications, such as pregnancy-related hypertension and cesarean delivery.
比较肥胖症女性在受孕后仍保持肥胖状态与未肥胖状态的妊娠结局。
从接受门诊围产期服务的女性数据库中，我们确定了目前怀有单胎妊娠且有减肥手术史的女性。使用 Fisher 确切检验、独立学生 t 检验和 Mann-Whitney U 检验比较了肥胖组（孕前体质量指数（PPBMI）≥30kg/m²）和非肥胖组（PPBMI＜30kg/m²）之间的产妇特征和妊娠结局。
在 102 名被识别的女性中，52 名（51%）在受孕时肥胖，50 名（49%）不肥胖。产妇年龄、婚姻状况、手术至分娩的年数、妊娠期糖尿病的发展、分娩时的胎龄、新生儿重症监护病房（NICU）入院率或保育天数均无差异。与非肥胖女性（<30kg/m²）相比，减肥手术后肥胖（≥30kg/m²）与更高的剖宫产率（63.5% vs. 36.0%，p=0.010）和妊娠相关高血压的发生（36.5% vs. 8.0%，p=0.001）相关。
减肥手术后，理想的目标应该是在受孕前达到非肥胖体重状态，以减少妊娠相关高血压和剖宫产等产妇并发症的发生。
