Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of Obstetrics and Gynaecology in Linköping, County Council of Östergötland, Linköping, Sweden.
BJOG. 2013 Nov;120(12):1477-82. doi: 10.1111/1471-0528.12365. Epub 2013 Aug 9.
To study the risk for congenital anomalies in the first child of women after bariatric surgery compared with all other women giving birth to their first child and divided by maternal body mass index (BMI) groups.
Prospective, population-based register study.
Sweden.
All firstborn children to women born 1973-83 were studied to determine if they had a congenital anomaly and a mother who had undergone bariatric surgery before pregnancy.
A total of 270,805 firstborns; of which 341 had mothers who had had bariatric surgery before delivery. We retrieved information on the women's marital or cohabitation status, smoking, BMI, diabetes and hypertension during pregnancy.
Congenital malformations.
Of the firstborn children to mothers who had had bariatric surgery before pregnancy, 4.1% (95% confidence interval [95% CI] 2.2-6.0) were malformed compared with 3.4% (95% CI 3.3-3.5) of those whose mothers had not undergone bariatric surgery. The risk for congenital malformation in firstborn children increased with increasing maternal BMI. The adjusted odds ratio (OR) for congenital malformation among children whose mothers' BMI ranged between 25 and 29 kg/m(2) was 1.09 (95% CI 1.03-1.15), whose mothers' BMI ranged between 30 and 34 kg/m(2) was 1.14 (1.05-1.24) and whose mothers' BMI was ≥35 kg/m(2) was 1.30 (95% CI 1.16-1.45) compared with those whose mothers had a normal BMI. Bariatric surgery before pregnancy did not have any effect on the odds ratio for having congenital malformation (OR = 1.09, 95% CI 0.63-1.91).
Preconception bariatric surgery does not seem to affect the risk for congenital malformations but a high to very high BMI does appear to increase the risk.
研究与所有其他初次分娩的女性相比，接受过减肥手术后的女性的第一个孩子出现先天性畸形的风险，并根据母亲的体重指数（BMI）进行分组。
前瞻性、基于人群的登记研究。
瑞典。
研究了所有 1973 年至 1983 年出生的初产妇，以确定她们的孩子是否存在先天性畸形，以及她们的母亲在怀孕前是否接受过减肥手术。
共有 270805 名初产妇，其中 341 名母亲在分娩前接受过减肥手术。我们检索了有关女性婚姻或同居状况、吸烟、BMI、孕期糖尿病和高血压的信息。
先天性畸形。
与未接受减肥手术的母亲所生的初产妇相比，接受减肥手术的母亲所生的初产妇中，4.1%（95%置信区间[95%CI]为 2.2%-6.0%）的孩子存在畸形，而未接受减肥手术的母亲所生的孩子中，这一比例为 3.4%（95%CI 为 3.3%-3.5%）。随着母亲 BMI 的增加，初产妇发生先天性畸形的风险也随之增加。母亲 BMI 在 25-29kg/m²之间的儿童发生先天性畸形的调整后比值比（OR）为 1.09（95%CI 为 1.03-1.15），母亲 BMI 在 30-34kg/m²之间的儿童为 1.14（95%CI 为 1.05-1.24），母亲 BMI≥35kg/m²的儿童为 1.30（95%CI 为 1.16-1.45），而母亲 BMI 正常的儿童为 1.00。怀孕前减肥手术对先天性畸形的比值比（OR=1.09，95%CI 为 0.63-1.91）没有影响。
孕前减肥手术似乎不会增加先天性畸形的风险，但高到极高的 BMI 似乎会增加这种风险。
