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Perinatal Outcomes After Bariatric Surgery Compared With a Matched Control Group.

Marie J Boller1, Fei Xu, Catherine Lee

  • 1Department of Obstetrics and Gynecology and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, the Permanente Medical Group, and the Kaiser Permanente Northern California Division of Research, Oakland, and the Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.

Obstetrics and Gynecology
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PubMed
Summary

Pregnancy after bariatric surgery is linked to lower rates of preeclampsia, gestational diabetes, and large-for-gestational-age (LGA) neonates. However, it is associated with a higher risk of small-for-gestational-age (SGA) neonates.

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Area of Science:

  • Obstetrics and Gynecology
  • Bariatric Surgery Outcomes
  • Perinatal Health

Background:

  • Bariatric surgery significantly impacts patient health, necessitating an understanding of pregnancy outcomes post-procedure.
  • Evaluating perinatal risks and benefits is crucial for guiding patient care and counseling.

Purpose of the Study:

  • To assess perinatal outcomes in pregnancies following bariatric surgery.
  • To compare outcomes between patients with and without a history of bariatric surgery using propensity score matching.

Main Methods:

  • Retrospective cohort study of 1,591 pregnancies post-bariatric surgery and 7,955 matched controls (2012-2018).
  • Propensity score matching accounted for numerous demographic and clinical variables.
  • Modified Poisson regression analyzed primary outcomes: preterm birth, gestational hypertension, preeclampsia, diabetes, LGA/SGA neonates, and cesarean delivery.

Main Results:

  • Pregnancy after bariatric surgery showed reduced risks of preeclampsia (aRR 0.72), gestational diabetes (aRR 0.73), and LGA neonates (aRR 0.56).
  • An increased risk of small-for-gestational-age (SGA) neonates was observed (aRR 1.51).
  • No significant differences were found in preterm birth, gestational hypertension, or cesarean delivery rates.

Conclusions:

  • Pregnancy following bariatric surgery is associated with a lower incidence of preeclampsia, gestational diabetes, and LGA neonates.
  • There is an elevated risk of SGA neonates in pregnancies after bariatric surgery compared to controls.
  • These findings are vital for managing pregnancies in women with a history of bariatric surgery.