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减肥手术后的母婴结局。

Maternal and fetal outcomes after bariatric surgeries.

作者信息

Farghali Mohamed M, Alhadhoud Fatemah K, AlObaidly Noura H, Mohammad Maryam, Abdelazim Ibrahim A, Amanzholkyzy Ainur, Khamidullina Zaituna

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Department of Obstetrics and Gynecology, Sabah Maternity Hospital, Kuwait.

出版信息

Prz Menopauzalny. 2023 Sep;22(3):148-154. doi: 10.5114/pm.2023.131440. Epub 2023 Sep 25.

Abstract

INTRODUCTION

Obesity is the most common medical problem affecting reproductive-age women. To detect the prevalence of obesity, and bariatric surgeries (BSs) in reproductive-age women, and the impact of obesity vs. BSs on the subsequent pregnancy outcomes.

MATERIAL AND METHODS

Obese-pregnant women, and women underwent BSs before the current pregnancy, with complete antenatal, and delivery records were included in the current study. Collected data were analyzed using MedCalc 20.106 to calculate the odd ratio (OR), and relative risk (RR) of adverse maternal, and fetal outcomes in relation to maternal obesity vs. BSs.

RESULTS

Data of 14,474 pregnant women were collected during this study; 33.94% (4912/14474) of them were obese, and 3.8% (546/14474) of them had previous BSs before the current pregnancy. The obese group has significantly higher odds, and RR of gestational diabetes mellitus (GDM) [OR 1.9 ( = 0.0001), and RR 1.79 ( = 0.0001)], gestational hypertension [OR 1.7 ( = 0.0002), and RR 1.6 ( = 0.0003)], and preeclampsia (PE) [OR 1.7 ( = 0.0001), and RR 1.6 ( = 0.0001)] compared to BSs group. The obese group has also significantly higher odds, and RR of cesarean sections (CSs) [OR 1.3 ( = 0.008), and RR 1.25 ( = 0.01)], and large for gestational age [OR 1.39 ( = 0.01), and RR 1.3 ( = 0.02)] compared to BSs group.

CONCLUSIONS

About 33.94% of the reproductive-age women in Kuwait are obese, and 3.8% of them had previous BSs. Obese-pregnant women are at increased risks of GDM, gestational hypertension, PE, and CSs. Bariatric surgeries reduced the rates of GDM, gestational hypertension, PE, and CSs significantly.

摘要

引言

肥胖是影响育龄妇女的最常见医学问题。旨在检测育龄妇女中肥胖症和减肥手术(BSs)的患病率,以及肥胖与减肥手术对后续妊娠结局的影响。

材料与方法

本研究纳入了肥胖孕妇以及在本次妊娠前接受过减肥手术且有完整产前和分娩记录的妇女。使用MedCalc 20.106对收集的数据进行分析,以计算与孕妇肥胖和减肥手术相关的不良母体和胎儿结局的比值比(OR)和相对风险(RR)。

结果

本研究期间收集了14474名孕妇的数据;其中33.94%(4912/14474)为肥胖孕妇,3.8%(546/14474)在本次妊娠前接受过减肥手术。与减肥手术组相比,肥胖组患妊娠期糖尿病(GDM)的OR [1.9(P = 0.0001)]和RR [1.79(P = 0.0001)]、妊娠期高血压的OR [1.7(P = 0.0002)]和RR [1.6(P = 0.0003)]以及先兆子痫(PE)的OR [1.7(P = 0.0001)]和RR [1.6(P = 0.0001)]显著更高。与减肥手术组相比,肥胖组剖宫产(CSs)的OR [1.3(P = 0.008)]和RR [1.25(P = 0.01)]以及大于胎龄儿的OR [1.39(P = 0.01)]和RR [1.3(P = 0.02)]也显著更高。

结论

科威特约33.94%的育龄妇女肥胖,其中3.8%曾接受过减肥手术。肥胖孕妇患GDM、妊娠期高血压、PE和CSs的风险增加。减肥手术显著降低了GDM、妊娠期高血压、PE和CSs的发生率。

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