LABS-2: Preoperative reproductive concerns prevalent in certain bariatric patients

Women with obesity who desire bariatric surgery often present with reproductive complications prior to surgery, results from a prospective study suggested.

Researchers with the six-center Longitudinal Assessment for Bariatric Surgery II (LABS-2) study reported that reproductive disorders like polycystic ovary syndrome, abnormal bleeding and menstrual cycles, and infertility were prevalent in the study cohort of obese women prior to undergoing bariatric surgery.

The researchers provided a self-administered 20-item reproductive health questionnaire to 1,024 women, according to Gabriella G. Gosman, MD, assistant professor of medicine at the University of Pittsburgh School of Medicine. She presented the results at the 25th Annual Meeting of the American Society for Metabolic and Bariatric Surgery in Washington.

“Among women presenting for bariatric surgery, there was a high prevalence of PCOS and abnormal menstrual function,” Gosman said. “Both of these have serious health consequences, including endometrial cancer.”

Gosman reported a higher prevalence of PCOS in the cohort compared with that of the general population (15.9% vs. 7%), as well as abnormal menses (32.2% vs. 18%). About 45% of the women in the cohort were reported as using estrogen-based contraceptives in the year leading up to bariatric surgery.

“We propose that clinicians determine whether future pregnancy is desired, and stratify women get counseling and care for the interaction between bariatric surgery and pregnancy, or for long-term reliable contraception,” she said. “Regardless of future pregnancy plans, all of these women would need reliable contraception from the decision to undergo surgery until the time that rapid weight loss has ceased.” – by Eric Raible

We are excited that the LABS data are starting to come out. I am concerned about the validation of this questionnaire. For it to be a reliable research tool, any questionnaire has to be validated. We have to be confident that it accurately measures what it is expected to measure in different populations and in different ways by different people. To draw data from it unless it has been validated and each component has been validated leaves us feeling uncertain of what we are looking at.

– Paul E. O’Brien, MD

Director, Center for Obesity & Education Monash University, South Yarra, Australia

For more information:
Gosman G. #PL 39. Reproductive health characteristics of women undergoing bariatric surgery. Presented at: the American Society for Metabolic and Bariatric Surgery’s Annual Scientific Meeting; June 15-20, 2008; Washington D.C.