Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Postgraduate Program in Medical Sciences, Endocrinology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Obes Surg. 2020 Aug;30(8):2963-2970. doi: 10.1007/s11695-020-04633-x.
To compare perinatal outcomes and to assess the predictors of birth weight (BW) after Roux-en-Y gastric bypass (RYGB) to those women unexposed to bariatric surgery.
Singleton births from women submitted to RYGB (BSG) were matched to two control births by maternal age, delivery year, and gender. Control group 1 (CG1) and control group 2 (CG2) were selected according to the prepregnancy body mass index (BMI) < 35 kg/m and ≥ 35 kg/m, respectively, without previous bariatric surgery.
Fifty-eight pregnancies were evaluated in each group (n = 174). Neonates born after RYGB presented lower BW compared to CG1 (mean difference - 182.3 g; 95% CI - 333; - 31, P = 0.018) and CG2 (mean difference - 306.6 g, 95% CI - 502; - 111, P = 0.02). Although gestational age (GA) was similar (P = 0.219), fetal growth rate (in grams) per gestational week was higher in CG2 (β = 196.27, P < 0.001) vs. BSG (β = 127.65, P < 0.001), irrespective of gestational weight gain (GWG). Pregnancies post-RYGB showed lower GWG, lower BW, and higher prevalence of cesarean section than CG1 and were associated with lower BW, smaller cephalic perimeter, lower prevalence of macrosomia, hypertension, and gestational diabetes than CG2.
Birth weight was higher in neonates from women with higher prepregnancy BMI, as compared to births from women submitted to RYGB, irrespective of GWG. Although nearly half of the RYGB mothers were classified with obesity at conception, those pregnancies were associated with better obstetric and neonatal outcomes than among women with prepregnancy BMI ≥ 35 kg/m who had never undergone RYGB.
比较 Roux-en-Y 胃旁路术（RYGB）后围产期结局，并评估出生体重（BW）的预测因素，与未接受减重手术的女性进行比较。
对接受 RYGB（BSG）的女性的单胎分娩进行匹配，按照母亲年龄、分娩年份和性别与两组对照分娩相匹配。对照组 1（CG1）和对照组 2（CG2）分别根据孕前体重指数（BMI）<35kg/m 和≥35kg/m 选择，且无既往减重手术史。
每组评估了 58 例妊娠（n=174）。与 CG1（平均差异-182.3g；95%CI-333；-31，P=0.018）和 CG2（平均差异-306.6g，95%CI-502；-111，P=0.02）相比，RYGB 后出生的新生儿 BW 较低。尽管 GA 相似（P=0.219），但 CG2 中每妊娠周胎儿生长速度（以克计）更高（β=196.27，P<0.001），而 BSG 则较低（β=127.65，P<0.001），与 GWG 无关。与 CG1 相比，RYGB 后的妊娠 GWG 较低、BW 较低、剖宫产率较高，且与 BW 较低、头围较小、巨大儿、高血压和妊娠期糖尿病的发生率较低有关，与 CG2 相比。
与接受 RYGB 的女性相比，孕前 BMI 较高的女性新生儿 BW 较高，而与 GWG 无关。尽管近一半的 RYGB 母亲在受孕时被归类为肥胖，但这些妊娠与肥胖相关的产科和新生儿结局较好，与从未接受 RYGB 的孕前 BMI≥35kg/m 的女性相比。
