Department of Obstetrics, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France.
Department of Hematology, La Cavale Blanche University Hospital, Boulevard Tanguy Prigent, Brest, France.
Surg Obes Relat Dis. 2020 Sep;16(9):1275-1282. doi: 10.1016/j.soard.2020.04.047. Epub 2020 May 11.
While the benefits of bariatric surgery (BS) on pregnancy outcomes have been demonstrated for women compared with matched controls on presurgery body mass index (pB-BMI), data are lacking and those benefits are uncertain compared with matched controls on prepregnancy BMI (pP-BMI).
Our study aimed to evaluate outcomes (obstetrical and neonatal) of single pregnancy in women previously exposed to BS compared with women unexposed to BS matched on pB-BMI and pP-BMI.
Retrospective matched cohort study from 2 observational studies of pregnant women conducted in a French administrative county (Finistère).
From April 1, 2015 to January 31, 2019, pregnant women with previous BS (n = 52) were included and compared with 2 different control groups as follows: group A (n = 104), matched for pB-BMI, age, and parity; and group B (n = 104), matched for pP-BMI, age, and parity.
In women exposed to BS, mean age was 27.1 (±4.9) years and pB-BMI was 46.0 (±4.6) kg/m. Operated women differed significantly from group A but not from group B for pP-BMI (29.4 ± 6.1 versus 45.3 ± 4.5 group A versus 28.6 ± 6.6 group B) and gestational diabetes (12.0% versus 44.0% group A versus 17.0% group B), respectively. In the group of women exposed to BS, birth weight (g) was significantly lower (2960 ± 545 versus 3381 ± 735 group A versus 3310 ± 645 group B) and large-for-gestational-age infants less frequent (0% versus 13% group A versus 8% group B).
Bariatric surgery reduced risks of excessive fetal growth and gestational diabetes with a trend for a higher risk of small-for-gestational-age, despite matching on pP-BMI suggesting a risk associated to BS and solely to previous surgery-induced weight loss.
与术前体重指数（pB-BMI）匹配的对照组相比，减重手术（BS）对妊娠结局的益处已在女性中得到证实，但与孕前体重指数（pP-BMI）匹配的对照组相比，数据仍缺乏且益处不确定。
本研究旨在评估与未接受 BS 治疗且 pB-BMI 和 pP-BMI 匹配的对照组相比，曾接受 BS 治疗的女性单胎妊娠的结局（产科和新生儿）。
在法国一个行政县（菲尼斯泰尔）进行的两项观察性孕妇研究的回顾性匹配队列研究。
从 2015 年 4 月 1 日至 2019 年 1 月 31 日，纳入了曾接受 BS 治疗的孕妇（n=52），并与以下两组不同的对照组进行比较：A 组（n=104），匹配 pB-BMI、年龄和产次；B 组（n=104），匹配 pP-BMI、年龄和产次。
在接受 BS 治疗的女性中，平均年龄为 27.1（±4.9）岁，pB-BMI 为 46.0（±4.6）kg/m。手术组与 A 组相比，pP-BMI（分别为 29.4±6.1 与 45.3±4.5 A 组与 28.6±6.6 B 组）和妊娠期糖尿病（分别为 12.0%与 44.0% A 组与 17.0% B 组）差异有统计学意义。在接受 BS 治疗的女性组中，出生体重（g）显著降低（分别为 2960±545 与 3381±735 A 组与 3310±645 B 组），巨大儿发生率降低（分别为 0%与 13% A 组与 8% B 组）。
尽管与 pP-BMI 匹配，但 BS 降低了胎儿过度生长和妊娠期糖尿病的风险，且胎儿小于胎龄儿的风险呈上升趋势，这表明与 BS 相关且仅与手术引起的体重减轻相关的风险。
