Chen Wenhui, Liang Yalun, Chen Guoji, Guo Jie, Dong Shiliang, Wang Cunchuan, Dong Zhiyong
Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Avenue West, Guangzhou, China.
Obes Surg. 2022 Apr;32(4):979-990. doi: 10.1007/s11695-021-05800-4. Epub 2022 Jan 22.
Current guidelines do not recommend pregnancy within 12 months after bariatric surgery; however, there is a lack of consensus and scientific evidence to support this. The study is to evaluate the influence of early pregnancy (≤ 12 months) after bariatric surgery on maternal and perinatal outcomes.
PubMed, Embase, Web of Science, and the Cochrane Library were searched for all studies comparing maternal and perinatal outcomes for surgery-to-conception intervals of ≤ 12 months and > 12 months.
A total of 13 studies were included. The pooled results showed that early pregnancy was associated with insufficient gestational weight gain (WMD: - 6.04, 95%CI [- 7.39, - 4.15], p < 0.01). No significant difference was found in gestational diabetes, gestational hypertension, preeclampsia, caesarean section, and postpartum hemorrhage between surgery-to-conception intervals of ≤ 12 months and > 12 months. There were also no significant differences between the two groups regarding the neonatal outcomes, including preterm birth, small for gestational age, large for gestational age, macrosomia, birth defect, neonatal intensive care unit admission, and Apgar score ≤ 7 within 5 min.
Early pregnancy (≤ 12 months) after bariatric surgery seems have no significant adverse effects on maternal and perinatal outcomes, with the exception of insufficient gestational weight gain. Pregnancy after bariatric surgery should be personalized based on the individual patient. Further studies on larger cohorts are warranted.
目前的指南不建议在减肥手术后12个月内怀孕；然而，缺乏支持这一建议的共识和科学证据。本研究旨在评估减肥手术后早期妊娠（≤12个月）对孕产妇和围产期结局的影响。
检索PubMed、Embase、Web of Science和Cochrane图书馆，查找所有比较手术至受孕间隔≤12个月和>12个月的孕产妇和围产期结局的研究。
共纳入13项研究。汇总结果显示，早期妊娠与孕期体重增加不足有关（加权均数差：-6.04，95%置信区间[-7.39，-4.15]，p<0.01）。手术至受孕间隔≤12个月和>12个月之间，在妊娠期糖尿病、妊娠期高血压、先兆子痫、剖宫产和产后出血方面未发现显著差异。两组在新生儿结局方面也无显著差异，包括早产、小于胎龄儿、大于胎龄儿、巨大儿、出生缺陷、新生儿重症监护病房入院率以及5分钟内Apgar评分≤7。
减肥手术后早期妊娠（≤12个月）除孕期体重增加不足外，似乎对孕产妇和围产期结局无显著不良影响。减肥手术后的妊娠应根据个体患者情况进行个性化处理。有必要对更大的队列进行进一步研究。
