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Roux-Y 胃旁路手术后 7 年内妊娠的母婴结局。

Maternal and Neonatal Outcomes of Pregnancy within 7 years after Roux-Y Gastric Bypass or Sleeve Gastrectomy Surgery.

机构信息

School of Medicine, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.

Department of Kinesiology, East Carolina University, E 5Th St, Greenville, NC, 27858, USA.

出版信息

Obes Surg. 2023 Jun;33(6):1764-1772. doi: 10.1007/s11695-023-06575-6. Epub 2023 Apr 4.

Abstract

PURPOSE

Few studies examine whether maternal and neonatal outcomes differ by time from metabolic and bariatric surgery (MBS) to conception. We describe maternal and neonatal outcomes among women with pregnancy after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) overall and by whether conception occurred during the period when pregnancy is not recommended (< 18 months postoperative) versus later.

MATERIALS AND METHODS

A prospective cohort study enrolled 135 US adult women (median age, 30 years, body mass index [BMI], 47.2 kg/m) who underwent RYGB or SG (2006-2009) and subsequently reported ≥ 1 pregnancy within 7 years. Participants self-reported pregnancy-related information annually. Differences in prevalence of maternal and neonatal outcomes by postoperative conception timeframe (< 18 versus ≥ 18 months) were assessed.

RESULTS

Thirty-one women reported ≥ 2 postoperative pregnancies. At time of postoperative conception (median 26 [IQR:22-52] months postoperative) median BMI was 31 (IQR:27-36) kg/m. Excessive gestational weight gain (55%), cesarean section (42%) and preterm labor or rupture of membranes (40%) were the most common maternal outcomes. Forty percent of neonates had a composite outcome of still birth (1%), preterm birth (26%), small for gestational age (11%), or neonatal intensive care unit admission (8%). Prevalence of outcomes did not statistically significantly differ by timeframe.

CONCLUSION

In US women who conceived ≤ 7 years following RYGB or SG, 40% of neonates had the composite neonatal outcome. The prevalence of maternal and neonatal outcomes post-MBS were not statistically significant by conception timeframe.

摘要

目的

很少有研究探讨代谢和减重手术(MBS)与受孕之间的时间间隔是否会导致母婴结局不同。我们描述了接受 Roux-en-Y 胃旁路术(RYGB)或袖状胃切除术(SG)的女性在总体和是否在不推荐妊娠的时间段(术后<18 个月)或之后受孕的情况下,母婴结局。

材料和方法

一项前瞻性队列研究纳入了 135 名美国成年女性(中位年龄 30 岁,体重指数 [BMI] 47.2kg/m),她们在 2006-2009 年间接受了 RYGB 或 SG,并且在 7 年内报告了≥1 次妊娠。参与者每年自行报告与妊娠相关的信息。通过术后受孕时间框架(<18 个月与≥18 个月)评估母婴结局的发生率差异。

结果

31 名女性报告了≥2 次术后妊娠。在术后受孕时(中位数 26 [IQR:22-52] 个月术后),BMI 的中位数为 31(IQR:27-36)kg/m。过度的妊娠体重增加(55%)、剖宫产(42%)和早产或胎膜早破(40%)是最常见的母婴结局。40%的新生儿存在复合结局,包括死胎(1%)、早产(26%)、小于胎龄儿(11%)或新生儿重症监护病房入住(8%)。结果的发生率在时间框架上没有统计学上的显著差异。

结论

在美国,在接受 RYGB 或 SG 后 7 年内受孕的女性中,有 40%的新生儿存在复合新生儿结局。MBS 后母婴结局的发生率与受孕时间框架无统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c0/10450590/b6e3497dcd53/nihms-1918416-f0001.jpg

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