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Licensed Unlicensed Requires Authentication Published by De Gruyter July 17, 2015

Maternal and perinatal outcomes after bariatric surgery: a case control study

  • Laura Arrais Sydrião de Alencar Costa , Edward Araujo Júnior EMAIL logo , Francisco Edson de Lucena Feitosa , Andréa Cavalcante Dos Santos , Luiz Gonzaga Moura Júnior and Francisco Herlânio Costa Carvalho

Abstract

Objective: To compare the results of maternal and perinatal pregnancies of obese women after bariatric surgery.

Methods: A retrospective cross-sectional study was carried out on 63 women who had undergone bariatric surgery and 73 obese women (control). Demographic data, the characteristics of the bariatric surgery, and the maternal and perinatal results were evaluated. The Student’s t-test and chi-square test (χ2) were used to compare the groups. The gestational complications of the prevalence of gestational diabetes mellitus, anemia, and preeclampsia were analyzed using simple and multivariate logistical regression and odd ratios (OD) with their respective confidence intervals (CI) of 95%.

Results: The average body mass index (BMI) at the 1st prenatal appointment of the control group was 34.6±3.3 kg/m2 and that of the post-surgical group was 26.5±4.2 kg/m2. The Roux-en-Y Gastric Bypass was used in 100% of cases; no complications were observed during or after the surgeries. The average weight loss in patients with a prior bariatric surgery was statistically significant (P=0.000). The average weight at birth of the control group was significantly higher than in the post-bariatric surgery group (P=0.017). The women who had a prior bariatric surgery had a higher chance of anemia (OR=3.5; CI 95%: 1.5–8.3) and a reduced chance of macrosomia (OR=0.2; CI 95%:0.1–0.5), and prematurity (OR=0.3; CI 95%:0.1–0.7).

Conclusion: Those women who had been submitted to bariatric surgery presented better maternal and perinatal results when compared to obese women.


Corresponding author: Prof. Edward Araujo Júnior, PhD, Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo-SP, Brazil, CEP 05089-030, Phone/Fax: +55-11-37965944, E-mail:

References

[1] World Health Organization. WHO. Overweight and obesity. Factsheet no. 311, World Health Organization, Geneva; 2006.Search in Google Scholar

[2] Coutinho T, Goel K, Corrêa de Sá D, Carter RE, Hodge DO, Kragelund C, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553–60.10.1016/j.jacc.2012.10.035Search in Google Scholar

[3] Schmidt MI, Duncan BB, Azevedo e Silva G, Menezes AM, Monteiro CA, Barreto SM, et al. Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet. 2011;377:1949–61.10.1016/S0140-6736(11)60135-9Search in Google Scholar

[4] Korenkov M. Bariatric surgery. New York: Springer; 2011.10.1007/978-3-642-16245-9Search in Google Scholar

[5] American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: Bariatric surgery and pregnancy. Obstet Gynecol. 2009;113:1405–13.10.1097/AOG.0b013e3181ac0544Search in Google Scholar PubMed

[6] Pathi A, Esen U, Hildreth A. A comparison of complications of pregnancy and delivery in morbidly obese and non-obese women. J Obstet Gynaecol. 2006;26:527–30.10.1080/01443610600810914Search in Google Scholar PubMed

[7] Wax JR, Cartin A, Wolff R, Lepich S, Pinette MG, Blackstone J. Pregnancy following gastric bypass for morbid obesity: effect of surgery-to-conception interval on maternal and neonatal outcomes. Obes Surg. 2008;18:1517–21.10.1007/s11695-008-9647-zSearch in Google Scholar PubMed

[8] Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103:219–24.10.1097/01.AOG.0000107291.46159.00Search in Google Scholar PubMed

[9] Fumery L, Pigeyre M, Fournier C, Arnalsteen L, Rivaux G, Subtil D, et al. Impact of bariatric surgery on obstetric prognosis. Gynecol Obstet Fertil. 2013;41:156–63.10.1016/j.gyobfe.2012.09.004Search in Google Scholar PubMed

[10] Lesko J, Peaceman A. Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls. Obstet Gynecol. 2012;119:547–54.10.1097/AOG.0b013e318239060eSearch in Google Scholar PubMed

[11] Kjaer MM, Nilas L. Pregnancy after bariatric surgery–a review of benefits and risks. Acta Obtet Gynecol Scand. 2013;92: 264–71.10.1111/aogs.12035Search in Google Scholar PubMed

[12] Aricha-Tamir B, Weintraub AY, Levi I, Sheiner E. Downsizing pregnancy complications: a study of paired pregnancy outcomes before and after bariatric surgery. Surg Obes Relat Dis. 2012;8:434–39.10.1016/j.soard.2011.12.009Search in Google Scholar

[13] Leech NL, Barrett KC, Morgan GA. SPSS for intermediate statistics: use and interpretation. London: Lawrence Erlbaum Associates; 2005.10.4324/9781410611420Search in Google Scholar

[14] Mendoza-Sassi RA, Cesar JA, Silva PR, Denardin G, Rodrigues MM. Risk factors for cesarean section by category of health service. Rev Saude Publica. 2010;44:80–9.10.1590/S0034-89102010000100009Search in Google Scholar

[15] El-Chaar D, Finkelstein SA, Tu X, Fell DB, Gaudet L, Sylvain J, et al. The impact of increasing obesity class on obstetrical outcomes. J Obstet Gynaecol Can. 2013;35:224–33.10.1016/S1701-2163(15)30994-4Search in Google Scholar

[16] Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.10.1381/0960892042387057Search in Google Scholar PubMed

[17] Karmon A, Sheiner E. Pregnancy after bariatric surgery: a comprehensive review. Arch Gynecol Obstet. 2008;277:381–8.10.1007/s00404-008-0608-5Search in Google Scholar PubMed

[18] Belogolovkin V, Salihu HM, Weldeselasse H, Biroscak BJ, August EM, Mbah AK, et al. Impact of prior bariatric surgery on maternal and fetal outcomes among obese and non-obese mothers. Arch Gynecol Obstet. 2012;285:1211–8.10.1007/s00404-011-2134-0Search in Google Scholar PubMed

[19] Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition. 2010;26:1031–7.10.1016/j.nut.2009.12.003Search in Google Scholar PubMed

[20] Facchiano E, Iannelli A, Santulli P, Mandelbrot L, Msika S. Pregnancy after laparoscopic bariatric surgery: comparative study of adjustable gastric banding and Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2012;8:429–33.10.1016/j.soard.2011.06.006Search in Google Scholar PubMed

[21] Faintuch J, Dias MC, de Souza Fazio E, de Oliveira FC, Nomura RM, Zugaib M, et al. Pregnancy nutritional indices and birth weight after Roux-en-Y gastric bypass. Obes Surg. 2009;19:583–9.10.1007/s11695-008-9755-9Search in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-3-14
Accepted: 2015-6-17
Published Online: 2015-7-17
Published in Print: 2016-5-1

©2016 by De Gruyter

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