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腹腔镜袖状胃切除术对妊娠、分娩和婴儿的影响:腹腔镜袖状胃切除术后妊娠时机是否影响结局?

The Influence of Laparoscopic Sleeve Gastrectomy on Pregnancy, Delivery, and Infant: Does Timing of Pregnancy Following Laparoscopic Sleeve Gastrectomy Affect Outcomes?

机构信息

Department of Surgery B, Carmel Medical Center, Affiliated With Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3436212, Haifa, Israel.

Division of Gynecology Oncology, Department of Obstetrics and Gynecology, Carmel Medical Center, Affiliated With Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Obes Surg. 2022 Aug;32(8):2567-2571. doi: 10.1007/s11695-022-06134-5. Epub 2022 Jun 15.

Abstract

PURPOSE

Maternal obesity is associated with newborn morbidity and mortality; however, the literature discussing bariatric surgical effects on women's fertility and pregnancy has reached diverse conclusions. We examined the effect of laparoscopic sleeve gastrectomy (LSG) on pregnancy, birth, and newborn outcomes regarding the time of conception.

MATERIALS AND METHODS

We conducted a retrospective review of women who had LSG and conceived between 2007 and 2017. Data included maternal parameters, pregnancy progression, delivery, and newborn status. Pregnancies were divided into subgroups according to surgery to conception interval (≤ 12, 12-24, ≥ 24 months).

RESULTS

We reviewed 68 patients: 48 (70%) conceived once, 13 (19%) conceived twice, 7 women (10%) conceived three times. There were 95 pregnancies and 80 live births. The group sizes were 18 (18.9%), 29 (30.5%), and 48 (50.5%) pregnancies for ≤ 12, 12-24, and 24 months after surgery, respectively. No difference was found between the subgroups regarding basic characteristics at time of surgery (age (p = 0.100), weight (p = 0.180), BMI (p = 0.616); and at beginning of pregnancy weight (p = 0.309), BMI (p = 0.707), %EBMIL (p = 0.321)). No significant differences were found concerning pregnancy progression, complications, and the newborns' weight (p = 0.41), GCT (p > 0.99), preeclampsia (p = 0.492), eclampsia (p > 0.99), Pre-term (p = 0.428), live birth (p = 0.432), LGA (p > 0.99), SGA (p = 0.732). A statistically significant trend of increased rates of caesarean section in subject with longer surgery-to-conception intervals was detected (P = 0.022).

CONCLUSIONS

Our results did not show that the interval between LSG and conception affects the pregnancy and newborn outcomes. Therefore, we believe that early conception following LSG does not increase the risk of maternal or neonatal morbidity or mortality.

摘要

目的

母体肥胖与新生儿发病率和死亡率有关;然而,关于减重手术对女性生育和妊娠影响的文献得出了不同的结论。我们研究了腹腔镜袖状胃切除术(LSG)对受孕时间相关的妊娠、分娩和新生儿结局的影响。

材料和方法

我们对 2007 年至 2017 年间接受 LSG 并受孕的女性进行了回顾性研究。数据包括产妇参数、妊娠进展、分娩和新生儿状况。根据手术至受孕间隔时间(≤12、12-24、≥24 个月)将妊娠分为亚组。

结果

我们共回顾了 68 例患者:48 例(70%)仅受孕 1 次,13 例(19%)受孕 2 次,7 例(10%)受孕 3 次。共有 95 例妊娠和 80 例活产。各组大小分别为手术后≤12、12-24 和 24 个月时的 18 例(18.9%)、29 例(30.5%)和 48 例(50.5%)。在手术时的基本特征(年龄(p=0.100)、体重(p=0.180)、BMI(p=0.616);以及妊娠开始时的体重(p=0.309)、BMI(p=0.707)、%EBMIL(p=0.321))方面,各亚组之间无差异。在妊娠进展、并发症和新生儿体重(p=0.41)、GCT(p>0.99)、子痫前期(p=0.492)、子痫(p>0.99)、早产(p=0.428)、活产(p=0.432)、LGA(p>0.99)、SGA(p=0.732)方面,未发现显著差异。发现手术至受孕间隔时间较长的患者剖宫产率呈上升趋势(P=0.022)。

结论

我们的结果表明,LSG 与受孕之间的间隔时间不会影响妊娠和新生儿结局。因此,我们认为 LSG 后早期受孕不会增加母婴发病率或死亡率的风险。

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