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Bariatric surgery influences pregnancy complications
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An increased risk for small for gestational age infants, shorter gestation and mortality is associated with bariatric surgery, according to recent study findings published in The New England Journal of Medicine.
However, bariatric surgery also was associated with decreased risks for gestational diabetes, and excessive fetal growth, according to the researchers.
“The effects of bariatric surgery on health outcomes, such as diabetes and cardiovascular disease, have been studied, but less is known about the effects on pregnancy and perinatal outcomes,” Kari Johansson, PhD, from the Karolinska Institutet in Sweden, said in a press release. “Therefore, we wanted to investigate if the surgery influenced in any way the risk of gestational diabetes, preterm birth, stillbirth, if the baby was small or large for its gestational age, congenital malformations and neonatal death.”
Kari Johansson
Johansson and colleagues evaluated 596 pregnancies of women who had given birth after bariatric surgery and 2,356 BMI-matched controls who had not had bariatric surgery from the Swedish Medical Birth Register to determine the risks for gestations diabetes, large for gestational age and small for gestational age infants, preterm birth, stillbirth, neonatal death and major congenital malformations among both groups.
Gestational diabetes occurred in more controls (6.8%) compared with postsurgical participants (1.9%; P < .001).
A lower risk for large for gestational age infants (P < .001) and macrosomia (P < .001) was found among postsurgical participants compared with controls. There was an increased risk for small for gestational age infants (P < .001), and a nonsignificant increase for low birth weight infants was found among postsurgical participants compared with controls.
No significant difference was found between the groups for preterm birth or congenital malformations. Postsurgical participants had a shorter gestation compared with controls (P < .001). Postsurgical participants also had a potentially greater combined risk for stillbirth or neonatal death (1.7%) compared with controls (0.7%). However, such events were uncommon and of borderline significance.
“Since bariatric surgery followed by pregnancy has both positive and negative effects, these women, when expecting, should be regarded as risk pregnancies,” Johansson said in the release. “They ought to be given special care from the maternal health services, such as extra ultrasound scans to monitor fetal growth, detailed dietary advice that includes checking the intake of the necessary postsurgery supplements.” – by Amber Cox
For more information:
Kari Johansson, PhD, can be reached at Department of Medicine Solna, Karolinska Institutet, Clinical Epidemiology Unit T2, Karolinska University Hospital, SE -171 Stockholm, Sweden; email: kari.johansson@ki.se.
Disclosure: The researchers report no relevant financial disclosures.
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