Highlights
- •Bariatric surgery (BS) reduces several obesity-related pregnancy complications.
- •BS may increase the risk of intrauterine growth restriction and preterm delivery.
- •BS mothers more frequently achieve the standard goal of breastfeeding for 6 months.
Abstract
Introduction
Bariatric surgery (BS) is known to reduce several obesity-related complications during
pregnancy, but there is concern that it may increase the risk of maternal-fetal morbidity
because of the malabsorption. This study aimed to investigate the impact of restrictive
BS on several pregnancy outcomes in comparison with different grades of obesity.
Materials and methods
A single-center retrospective case-control study. All primiparous singleton pregnant
women who underwent BS between the previous 1–5 years or with body mass index (BMI) ≥ 30 kg/m2 delivering in our center were included. Obstetric and perinatal outcomes were analyzed
and compared between the two groups.
Results
Overall, 90 women were included: 30 underwent BS and 60 were obese. The mean pre-pregnancy
BMI was 31.0 ± 4.2 kg/m2 in the BS group and 38.1 ± 4.3 kg/m2 in the control group (p < 0.001). The obese group experienced higher rate of fetal
macrosomia (25% vs 6.7%; p = 0.049), gestational hypertension (23.3% vs 3.3%; p = 0.04),
preeclampsia (23.3% vs 0%; p = 0.04), gestational diabetes (33.3% vs 6.7%; p = 0.01),
and cesarean section (68.3% vs 20%; p < 0.0001). The BS group showed higher frequency
of small for gestational age (SGA) (46.7% vs 18.3%; p = 0.006), late preterm delivery
(PTD) (33.3% vs 10%; p = 0.009), cholestasis (13.3% vs 1.7%; p = 0.049). Breastfeeding ≥ 6 months
was higher among BS mothers (36.7% vs 11.7%; p = 0.007).
Conclusions
Our findings support the positive impact of BS on several obstetric outcomes, at the
expense of a higher frequency of SGA and PTD. BS mothers more frequently achieved
the recommended goal of breastfeeding for 6 months compared to obese women.
Keywords
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Article info
Publication history
Published online: March 08, 2022
Accepted:
March 4,
2022
Received in revised form:
February 13,
2022
Received:
December 13,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
