Bariatric surgery improves health outcomes of pregnancy in obese females: Study

Bariatric surgery is a common treatment modality to manage obesity that generally provides prolonged weight control and added health benefits. As per recent studies, a large number of women are becoming pregnant after bariatric surgery; however, there is limited evidence on its impact on perinatal outcomes.

A group of researchers from Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA, conducted a study to investigate the association between bariatric surgery and risk of adverse perinatal outcomes in pregnant women and to demonstrate if the risk is modified by the post-surgery weight, gestational weight gain, type of bariatric surgery, the timing of pregnancy after bariatric surgery, and maternal comorbidities.

The researchers performed a retrospective cohort study using the Bariatric Surgery Registry, Hospital Inpatient, and Outpatient physician encounter records. They used the International Classification of Diseases-9/10 codes from hospitalizations during pregnancy and infant birth records to confirm the outcomes of interest.

A total of 20,213 eligible women for bariatric surgery and had delivered at ≥20 weeks of gestation in Kaiser Permanente Southern California hospitals from January 1, 2007, to December 31, 2018, participated in the study.

Adjusted odds ratios were derived from logistic regression models, with inverse probability of treatment weighting to adjust for confounding using propensity score.

The results of the study are as follows:

· Bariatric surgery was associated with reduced risk of gestational diabetes, chorioamnionitis, cesarean delivery, large for gestational age, macrosomia, and neonatal intensive care unit admission.

· However, bariatric surgery was associated with significantly increased risk of small for gestational age birth.

· The risk of the adverse outcomes are independent of the interval between the surgery and subsequent pregnancy.

Thus, the researchers concluded that there are many pregnancy outcome benefits for severely obese women who have bariatric surgery was done; but, women with bariatric surgery before pregnancy should be monitored closely to reduce small for gestational age birth and postpartum hemorrhage.

Reference:

Perinatal outcomes after bariatric surgery by Getahun D et. al published in the American Journal of Obstetrics & Gynecology.

DOI: https://doi.org/10.1016/j.ajog.2021.06.087