School of Nursing, University of Rochester, Rochester, New York.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Surg Obes Relat Dis. 2022 Nov;18(11):1304-1312. doi: 10.1016/j.soard.2022.07.013. Epub 2022 Aug 2.
Bariatric surgery has been shown to increase the risk for preterm birth in a subsequent pregnancy. Determining factors that contribute to this heightened risk will inform the development of targeted interventions to improve birth outcomes postbariatric surgery.
This study aimed to identify risk factors of preterm birth in pregnancies following bariatric surgery. Factors being considered were preoperative medical conditions and behaviors (e.g., obesity-associated co-morbidities, gastrointestinal symptoms, substance use), antenatal factors (e.g., prepregnancy body mass index, gestational weight gain), and surgery-specific factors (e.g., surgery type, surgery-to-conception interval).
Bariatric surgery centers in the United States.
This is a retrospective analysis of the Longitudinal Assessment of Bariatric Surgery-2. Participants were women who reported at least 1 singleton live birth during the 7-year postoperative period. Logistic regressions were used to identify risk factors of preterm birth, adjusting for covariates such as maternal age, race, and ethnicity.
Participants (n = 97) were mostly White (84.5%) and non-Hispanic (88.7%). At the time of surgery, the mean age was 29.4 ± 4.6 years, and the mean body mass index was 47.6 ± 6.3 kg/m. The prevalence of preterm birth was 13.4%. Preoperative gastrointestinal symptoms significantly increased (odds ratio: 1.12; 95% confidence interval: 1.00-1.26), while unexpectedly, excessive versus adequate gestational weight gain (odds ratio: .12; 95% confidence interval: .02-1.00) decreased the odds of preterm birth following bariatric surgery.
This analysis identified potential risk and protective factors of preterm birth among pregnancies postbariatric surgery. However, given the small sample size, findings should be regarded as hypothesis-generating and merit further study.
减重手术已被证实会增加后续妊娠早产的风险。确定导致这种风险增加的因素将有助于制定有针对性的干预措施，以改善减重手术后的生育结局。
本研究旨在确定减重手术后妊娠早产的危险因素。考虑的因素包括术前的医疗条件和行为（例如，肥胖相关的合并症、胃肠道症状、物质使用）、产前因素（例如，孕前体重指数、妊娠期体重增加）和手术特定因素（例如，手术类型、手术至受孕间隔）。
美国的减重手术中心。
这是对纵向评估减重手术-2 的回顾性分析。参与者是在术后 7 年内至少报告过一次单胎活产的女性。使用逻辑回归来确定早产的危险因素，并调整了产妇年龄、种族和民族等协变量。
参与者（n=97）主要为白人（84.5%）和非西班牙裔（88.7%）。手术时的平均年龄为 29.4±4.6 岁，平均体重指数为 47.6±6.3kg/m²。早产的患病率为 13.4%。术前胃肠道症状显著增加（优势比：1.12；95%置信区间：1.00-1.26），而出乎意料的是，与适量相比，过度妊娠期体重增加（优势比：0.12；95%置信区间：0.02-1.00）降低了减重手术后早产的风险。
本分析确定了减重手术后妊娠早产的潜在风险和保护因素。然而，由于样本量小，研究结果应被视为假设产生，并值得进一步研究。
