Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls

Jennifer Lesko*, Alan M Peaceman

*Corresponding author for this work

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

OBJECTIVE: To estimate the rates of pregnancy outcomes of women after bariatric surgery relative to women in a control groups. METHODS: The study was a chart review. Presurgery and prepregnancy body mass index (BMI) were calculated for 70 patients who had undergone bariatric surgery and who had a subsequent singleton pregnancy. Four control patients were then randomly selected for each case patient: two with a BMI within 6 points of the average presurgery BMI and two with a BMI within 6 points of the average prepregnancy BMI. The primary outcomes were the rates of gestational diabetes or hypertensive disorders of pregnancy. RESULTS: There was a significant decrease in rate of gestational diabetes in bariatric surgery patients (0.0%) as compared with both control groups (morbidly obese 16.4%, obese 9.3%; corrected odds ratio (OR) morbidly obese 0.04, with a 95% confidence interval [CI] 0.00-0.62, P<.01; corrected OR obese 0.07, CI 0.00-1.20, P=.01). There was no significant difference in the rate of hypertensive disorders of pregnancy with bariatric surgery. Additionally, neonates were significantly more likely to be small for gestational age (SGA) in the bariatric surgery group (17.4%) than the morbidly obese group (5.0%) (OR 3.94, CI 1.47-10.53, P<.01). CONCLUSION: Bariatric surgery is associated with reduction in gestational diabetes in a subsequent pregnancy, but possibly at the expense of an increase in SGA neonates. LEVEL OF EVIDENCE: II.

Original languageEnglish (US)
Pages (from-to)547-554
Number of pages8
JournalObstetrics and Gynecology
Volume119
Issue number3
DOIs
StatePublished - Mar 1 2012

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Bariatric Surgery
Pregnancy Outcome
Body Mass Index
Gestational Diabetes
Pregnancy
Odds Ratio
Confidence Intervals
Gestational Age
Newborn Infant
Control Groups

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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title = "Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls",
abstract = "OBJECTIVE: To estimate the rates of pregnancy outcomes of women after bariatric surgery relative to women in a control groups. METHODS: The study was a chart review. Presurgery and prepregnancy body mass index (BMI) were calculated for 70 patients who had undergone bariatric surgery and who had a subsequent singleton pregnancy. Four control patients were then randomly selected for each case patient: two with a BMI within 6 points of the average presurgery BMI and two with a BMI within 6 points of the average prepregnancy BMI. The primary outcomes were the rates of gestational diabetes or hypertensive disorders of pregnancy. RESULTS: There was a significant decrease in rate of gestational diabetes in bariatric surgery patients (0.0{\%}) as compared with both control groups (morbidly obese 16.4{\%}, obese 9.3{\%}; corrected odds ratio (OR) morbidly obese 0.04, with a 95{\%} confidence interval [CI] 0.00-0.62, P<.01; corrected OR obese 0.07, CI 0.00-1.20, P=.01). There was no significant difference in the rate of hypertensive disorders of pregnancy with bariatric surgery. Additionally, neonates were significantly more likely to be small for gestational age (SGA) in the bariatric surgery group (17.4{\%}) than the morbidly obese group (5.0{\%}) (OR 3.94, CI 1.47-10.53, P<.01). CONCLUSION: Bariatric surgery is associated with reduction in gestational diabetes in a subsequent pregnancy, but possibly at the expense of an increase in SGA neonates. LEVEL OF EVIDENCE: II.",
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Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls. / Lesko, Jennifer; Peaceman, Alan M.

In: Obstetrics and Gynecology, Vol. 119, No. 3, 01.03.2012, p. 547-554.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls

AU - Lesko, Jennifer

AU - Peaceman, Alan M

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N2 - OBJECTIVE: To estimate the rates of pregnancy outcomes of women after bariatric surgery relative to women in a control groups. METHODS: The study was a chart review. Presurgery and prepregnancy body mass index (BMI) were calculated for 70 patients who had undergone bariatric surgery and who had a subsequent singleton pregnancy. Four control patients were then randomly selected for each case patient: two with a BMI within 6 points of the average presurgery BMI and two with a BMI within 6 points of the average prepregnancy BMI. The primary outcomes were the rates of gestational diabetes or hypertensive disorders of pregnancy. RESULTS: There was a significant decrease in rate of gestational diabetes in bariatric surgery patients (0.0%) as compared with both control groups (morbidly obese 16.4%, obese 9.3%; corrected odds ratio (OR) morbidly obese 0.04, with a 95% confidence interval [CI] 0.00-0.62, P<.01; corrected OR obese 0.07, CI 0.00-1.20, P=.01). There was no significant difference in the rate of hypertensive disorders of pregnancy with bariatric surgery. Additionally, neonates were significantly more likely to be small for gestational age (SGA) in the bariatric surgery group (17.4%) than the morbidly obese group (5.0%) (OR 3.94, CI 1.47-10.53, P<.01). CONCLUSION: Bariatric surgery is associated with reduction in gestational diabetes in a subsequent pregnancy, but possibly at the expense of an increase in SGA neonates. LEVEL OF EVIDENCE: II.

AB - OBJECTIVE: To estimate the rates of pregnancy outcomes of women after bariatric surgery relative to women in a control groups. METHODS: The study was a chart review. Presurgery and prepregnancy body mass index (BMI) were calculated for 70 patients who had undergone bariatric surgery and who had a subsequent singleton pregnancy. Four control patients were then randomly selected for each case patient: two with a BMI within 6 points of the average presurgery BMI and two with a BMI within 6 points of the average prepregnancy BMI. The primary outcomes were the rates of gestational diabetes or hypertensive disorders of pregnancy. RESULTS: There was a significant decrease in rate of gestational diabetes in bariatric surgery patients (0.0%) as compared with both control groups (morbidly obese 16.4%, obese 9.3%; corrected odds ratio (OR) morbidly obese 0.04, with a 95% confidence interval [CI] 0.00-0.62, P<.01; corrected OR obese 0.07, CI 0.00-1.20, P=.01). There was no significant difference in the rate of hypertensive disorders of pregnancy with bariatric surgery. Additionally, neonates were significantly more likely to be small for gestational age (SGA) in the bariatric surgery group (17.4%) than the morbidly obese group (5.0%) (OR 3.94, CI 1.47-10.53, P<.01). CONCLUSION: Bariatric surgery is associated with reduction in gestational diabetes in a subsequent pregnancy, but possibly at the expense of an increase in SGA neonates. LEVEL OF EVIDENCE: II.

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