Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Obstetrics and Gynecology, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.
J Obstet Gynaecol. 2020 Jul;40(5):614-618. doi: 10.1080/01443615.2019.1634024. Epub 2019 Sep 3.
The optimal interval between bariatric surgery (BS) and pregnancy remains clearly undefined. The aim of this study was to assess pregnancy outcomes according to the interval from BS to conception. The nationwide study cohort consisted of 130 women with previous BS and postoperative singleton delivery during 2005-2015 in Lithuania. Women who conceived within the first 12 months after BS were included in the early conception (EC) group ( = 30); who became pregnant after 1 year were included in the late conception (LC) group ( = 100). Mean surgery-to-conception time in the EC group was 6.9 ± 3.5 months; in the LC group was 41.4 ± 21.6 months. Anaemia was diagnosed significantly more frequently in women who conceived after 12 months compared with the EC group (56.0% versus 33.3%, = .04). No significant differences were found between the EC and the LC group regarding gestational diabetes, preeclampsia, caesarean section rate, and adverse neonatal outcomes.Impact statement Bariatric surgery is recognized as a safe and highly effective approach to obesity treatment. Optimal interval between bariatric surgery and conception remains undefined, however most bariatric surgeons advise patients to delay pregnancy for 12-18 months. The results of our study did not show significant differences in pregnancy complications and neonatal outcomes in women who conceived within the first 12 postoperative months and in women who conceived later. Women who become pregnant within the first year after surgery, should be reassured that obstetric complication rates generally are low. Patients with prior BS should be provided with multidisciplinary prenatal care and screening for nutritional deficiencies during pregnancy. Further studies are needed to determine the optimal interval after BS and to assess the influence this interval has on perinatal outcomes.
肥胖症手术(BS)和妊娠之间的最佳间隔时间仍未明确界定。本研究旨在根据 BS 到受孕的时间间隔评估妊娠结局。这项全国性的研究队列包括 130 名在立陶宛于 2005 年至 2015 年间进行过 BS 并术后单胎分娩的女性。将 BS 后 12 个月内受孕的女性纳入早期受孕(EC)组( = 30);1 年后怀孕的女性纳入晚期受孕(LC)组( = 100)。EC 组的手术至受孕时间平均为 6.9 ± 3.5 个月;LC 组为 41.4 ± 21.6 个月。与 EC 组相比,12 个月后受孕的女性贫血诊断明显更为常见(56.0%与 33.3%, = .04)。EC 组和 LC 组在妊娠糖尿病、子痫前期、剖宫产率和不良新生儿结局方面无显著差异。
研究结果并未显示在术后 12 个月内受孕和较晚受孕的女性在妊娠并发症和新生儿结局方面存在显著差异。因此,手术后一年内怀孕的女性应该放心,产科并发症的发生率通常较低。有 BS 病史的患者应接受多学科的产前护理,并在怀孕期间筛查营养缺乏症。需要进一步研究来确定 BS 后的最佳间隔时间,并评估这段间隔对围产期结局的影响。