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育龄妇女的减重手术。

Bariatric surgery in women of childbearing age.

机构信息

Faculty of Medical and Human Sciences, The University of Manchester, UK.

出版信息

QJM. 2013 Aug;106(8):717-20. doi: 10.1093/qjmed/hct081. Epub 2013 Apr 9.

Abstract

BACKGROUND

Although bariatric surgery in women of childbearing age reduces the risks of pregnancy complications associated with maternal obesity, little is known of the effect of gestation on weight loss outcomes.

AIM

To study weight loss and pregnancy outcomes after bariatric surgery in women of childbearing age.

DESIGN AND METHODS

We performed a retrospective, observational cohort analysis of women aged 18-45 years in a university teaching hospital. The results shown represent mean ± standard deviation where appropriate.

RESULTS

A total of 232 women aged 34.0 ± 5.9 years with pre-operative weight 137.7 ± 21.3 kg and body mass index (BMI) 50.6 ± 7.2 kg/m(2) underwent bariatric surgery that included 197 (84.9%) gastric bypass, 19 (8.2%) gastric banding, 8 (3.4%) sleeve gastrectomy and 8 other procedures. Twenty-one women had 28 pregnancies following bariatric surgery, of which 24 (85.7%) resulted in live births, 3 (10.7%) terminations of pregnancy and 1 (3.6%) spontaneous miscarriage. The pregnancy group was younger compared with the non-pregnancy group (28.0 ± 5.4 vs. 34.6 ± 5.6 years; P < 0.001) but well matched for pre-operative weight (136.5 ± 18.5 vs. 137.8 ± 21.6 kg), BMI (49.2 ± 7.4 vs. 50.7 ± 7.2 kg/m(2)) and bariatric procedure. The interval between bariatric surgery and first pregnancy was a median 11 months. The pregnancy group lost 70.4% of excess weight compared with 70.0% in the non-pregnancy group at median 30 months of follow-up.

CONCLUSION

Pregnancy after bariatric surgery is safe and does not adversely affect weight loss outcomes.

摘要

背景

尽管生育年龄的女性进行减重手术可以降低与肥胖相关的妊娠并发症的风险,但关于妊娠对减重效果的影响知之甚少。

目的

研究生育年龄女性接受减重手术后的减重效果和妊娠结局。

设计和方法

我们对一所大学教学医院中年龄在 18-45 岁的女性进行了回顾性、观察性队列分析。适当情况下,结果以平均值±标准差表示。

结果

共有 232 名年龄 34.0±5.9 岁、术前体重 137.7±21.3kg 和体重指数(BMI)50.6±7.2kg/m²的女性接受了减重手术,其中 197 名(84.9%)接受了胃旁路手术,19 名(8.2%)接受了胃束带手术,8 名(3.4%)接受了袖状胃切除术,还有 8 名接受了其他手术。21 名女性在减重手术后经历了 28 次妊娠,其中 24 次(85.7%)为活产,3 次(10.7%)为妊娠终止,1 次(3.6%)为自然流产。妊娠组比非妊娠组更年轻(28.0±5.4 岁比 34.6±5.6 岁;P<0.001),但术前体重(136.5±18.5kg 比 137.8±21.6kg)、BMI(49.2±7.4kg/m²比 50.7±7.2kg/m²)和减重手术方式匹配良好。减重手术和首次妊娠之间的间隔中位数为 11 个月。在中位 30 个月的随访中,妊娠组的体重减轻了 70.4%,而非妊娠组为 70.0%。

结论

减重手术后妊娠是安全的,不会对减重效果产生不利影响。

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