School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd, Stanford, CA, 94305, USA.
Obes Surg. 2022 Nov;32(11):3696-3704. doi: 10.1007/s11695-022-06283-7. Epub 2022 Sep 22.
Bariatric surgery is associated with elevated risks for adverse birth outcomes, such as small-for-gestational-age infants (SGA). Maternal mental health is a critical regulator of fetal growth, but it is largely overlooked in pregnant women post-surgery. This study aimed to examine the associations between maternal mental health and birth outcomes in pregnant women post-bariatric surgery.
This was a retrospective analysis of medical records of women who had a singleton delivery following Roux-en-Y gastric bypass or sleeve gastrectomy. Mental health measures included depression/anxiety and substance use (cigarettes, alcohol, opioids, and marijuana). Birth outcomes were fetal growth restriction, SGA, low birthweight, and preterm birth. Logistic regressions were used to assess the associations between maternal mental health and each of the birth outcomes. A post hoc logistic regression was conducted to assess factors that influenced maternal marijuana use.
Participants (N = 179) were mostly white (64.6%), non-Hispanic (84.5%), with a mean age of 32.7 ± 4.6 years, and mean body mass index of 37.2 ± 8.4 kg/m at conception. Maternal marijuana use significantly increased the odds for fetal growth restriction, SGA, low birthweight, and preterm birth. Cigarette use increased the risk for low birthweight. Conversely, alcohol use was protective of low birthweight and preterm birth. A post hoc analysis revealed that married women were less likely to use marijuana than those who were single, divorced, or widowed.
This analysis identified marijuana and cigarette use as risk factors for adverse birth outcomes post-bariatric surgery. Future studies with larger sample sizes are needed to confirm study findings.
减重手术与不良生育结局相关，如小于胎龄儿（SGA）。产妇心理健康是胎儿生长的关键调节剂，但在手术后的孕妇中，这一点在很大程度上被忽视了。本研究旨在探讨减重手术后孕妇的心理健康与生育结局之间的关系。
这是一项对接受 Roux-en-Y 胃旁路术或袖状胃切除术的单胎分娩后女性病历进行的回顾性分析。心理健康测量包括抑郁/焦虑和物质使用（香烟、酒精、阿片类药物和大麻）。生育结局包括胎儿生长受限、SGA、低出生体重和早产。逻辑回归用于评估产妇心理健康与每种生育结局之间的关系。进行了事后逻辑回归以评估影响产妇使用大麻的因素。
参与者（N=179）主要为白人（64.6%），非西班牙裔（84.5%），平均年龄为 32.7±4.6 岁，平均体重指数为 37.2±8.4kg/m2 在受孕时。产妇使用大麻显著增加了胎儿生长受限、SGA、低出生体重和早产的几率。吸烟增加了低出生体重的风险。相反，饮酒可预防低出生体重和早产。事后分析显示，已婚女性使用大麻的可能性低于单身、离婚或丧偶女性。
这项分析确定了大麻和香烟使用是减重手术后不良生育结局的危险因素。需要更大样本量的未来研究来证实研究结果。
