Marion County Public Health Department, 3838 N Rural St, Indianapolis, IN, 46205, USA.
College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA.
Obes Surg. 2023 Aug;33(8):2276-2281. doi: 10.1007/s11695-023-06678-0. Epub 2023 Jun 17.
As the utilization of metabolic and bariatric surgery (MBS) continues to rise, it is important to address the nutritional needs of women who had MBS who become pregnant. Not meeting those nutritional needs could lead to complications associated with malnutrition. To better understand the relationship between MBS, pregnancy, and malnutrition, this study sought to determine whether differences exist in the presence of malnutrition during pregnancy in women with a history of MBS compared to women without a history of MBS.
This cross-sectional study used the National Inpatient Sample (NIS) from 2012 to 2017, which samples 20% of hospital discharges in the USA. Multivariate logistic regression models were fitted, and odds rations and 95% confidence intervals were calculated with obesity and MBS as the independent variables and malnutrition during pregnancy as the dependent variable. Covariates included in the multivariate model were age, primary payer, hypertension, hyperlipidemia, and depression.
Compared to women who did not have MBS, women who had MBS had higher odds of malnutrition during pregnancy (aOR = 8.33, 95% CI 7.30-9.50), this result was moderated by racial category (aOR = 6.35, 95% CI 4.97-8.13; aOR = 8.25, 95% CI 7.00-9.73; aOR = 10.93, 95% CI 8.38-14.25). Women with obesity also had higher odds of malnutrition during pregnancy.
The increased odds of malnutrition among women with MBS suggests that it is important to consider tailoring nutrition recommendations to address the different nutritional needs of pregnant women who had MBS and may be at risk for malnutrition.
随着代谢和减重手术（MBS）的应用不断增加，了解接受过 MBS 并怀孕的女性的营养需求变得尤为重要。未能满足这些营养需求可能会导致与营养不良相关的并发症。为了更好地了解 MBS、怀孕和营养不良之间的关系，本研究旨在确定与没有 MBS 病史的女性相比，有 MBS 病史的女性在怀孕期间是否存在营养不良的差异。
本横断面研究使用了 2012 年至 2017 年的国家住院患者样本（NIS），该样本取自美国 20%的住院患者出院记录。使用多元逻辑回归模型，将肥胖和 MBS 作为自变量，将怀孕期间的营养不良作为因变量，计算比值比和 95%置信区间。纳入多元模型的协变量包括年龄、主要支付方、高血压、高血脂和抑郁症。
与没有 MBS 的女性相比，有 MBS 的女性在怀孕期间发生营养不良的可能性更高（调整后比值比[aOR] = 8.33，95%置信区间[95%CI] 7.30-9.50），这一结果受到种族类别的调节（aOR = 6.35，95%CI 4.97-8.13；aOR = 8.25，95%CI 7.00-9.73；aOR = 10.93，95%CI 8.38-14.25）。肥胖女性在怀孕期间发生营养不良的可能性也更高。
MBS 女性发生营养不良的几率增加表明，重要的是要考虑定制营养建议，以满足接受过 MBS 且可能存在营养不良风险的孕妇的不同营养需求。
