Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA.
Arch Gynecol Obstet. 2012 May;285(5):1211-8. doi: 10.1007/s00404-011-2134-0. Epub 2011 Nov 6.
To assess the association between bariatric surgery and pregnancy-related outcomes among obese and non-obese women in the state of Florida.
We conducted a population-based, retrospective cohort analysis using vital records and hospital discharge data in Florida during 2004-2007. Women were categorized based on prior bariatric surgery and pre-pregnancy obesity status. Maternal complications (i.e., anemia, pre-eclampsia, gestational diabetes, chronic hypertension, endocrine disorders, cesarean section, prolonged hospital stay) and fetal morbidities [macrosomia, preterm birth, small for gestational age (SGA)] were the outcomes of interest. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were computed.
Mothers with a prior history of bariatric surgery, regardless of obesity status, were more likely to have anemia, chronic hypertension, endocrine disorders, and SGA infants. Classification based on prior history of bariatric surgery and obesity status showed that non-obese mothers with prior bariatric surgery were more likely to have anemia, chronic hypertension, endocrine disorders, and SGA infants, whereas obese mothers without prior bariatric surgery were at greater risk of having gestational diabetes, chronic hypertension, macrosomic infants (AOR = 1.69, 95% CI = 1.65-1.73), and prolonged hospital stay as compared to non-obese mother without prior bariatric surgery.
Although prior bariatric surgery is associated with multiple negative maternal and fetal outcomes, it is protective against infant macrosomia in obese mothers. Our findings support the need for preconception/interconception services tailored for former bariatric surgery patients to improve maternal and feto-infant health outcomes.
评估佛罗里达州肥胖和非肥胖女性中减肥手术与妊娠相关结局的关联。
我们使用佛罗里达州 2004-2007 年期间的生命记录和住院数据进行了一项基于人群的回顾性队列分析。根据减肥手术前和孕前肥胖状况对女性进行分类。感兴趣的母婴并发症（即贫血、先兆子痫、妊娠期糖尿病、慢性高血压、内分泌紊乱、剖宫产、住院时间延长）和胎儿畸形（巨大儿、早产、小于胎龄儿（SGA））是研究结局。计算了调整后的优势比（AOR）和 95%置信区间（CI）。
无论肥胖状况如何，有减肥手术史的母亲更有可能出现贫血、慢性高血压、内分泌紊乱和 SGA 婴儿。根据减肥手术史和肥胖状况的分类显示，有减肥手术史的非肥胖母亲更有可能出现贫血、慢性高血压、内分泌紊乱和 SGA 婴儿，而没有减肥手术史的肥胖母亲则更有可能出现妊娠期糖尿病、慢性高血压、巨大儿（AOR=1.69，95%CI=1.65-1.73）和住院时间延长，与没有减肥手术史的非肥胖母亲相比。
尽管减肥手术与多种母婴负面结局相关，但它对肥胖母亲的婴儿巨大儿有保护作用。我们的研究结果支持为减肥手术患者提供孕前/孕中服务的必要性，以改善母婴和胎儿健康结局。
