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Time between bariatric surgery, childbirth influences neonatal health risks
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The risks for prematurity, neonatal ICU admission and small for gestational age status are elevated among infants whose mothers had bariatric surgery less than 2 years before giving birth compared with those of mothers who did not undergo such procedures, study data show.
Brodie Parent, MD, of the department of surgery at the University of Washington Medical Center in Seattle, and colleagues conducted a population-based retrospective cohort study of data from 10,296 women (median age, 29 years) seen at hospitals in Washington state between 1980 and May 2013 to determine whether bariatric surgery is associated with perinatal complications. Participants were divided into groups based on surgical status: postoperative mothers and their infants (n = 1,859) and nonoperative mothers and their infants (n = 8,437).
Compared with infants of mothers who did not undergo surgery, infants of mothers who underwent surgery were more likely to be born at less than 37 weeks’ gestation (RR = 1.57; 95% CI, 1.33-1.85), were more likely to be born at less than 32 weeks’ gestation (RR = 1.71; 95% CI, 1.16-2.01) and were more likely to require admission to the neonatal ICU (RR = 1.25; 95% CI, 1.08-1.44). The risks for small for gestational age status (RR = 1.93; 95% CI, 1.65-2.26) and a low Apgar score of 8 or less (RR = 1.21; 95% CI, 1.06-1.37) were higher among infants of mother who underwent surgery compared with those whose mothers did not, but the risk for large for gestational age status was lower (RR = 0.53; 95% CI, 0.44-0.65).
The risks for prematurity (RR = 1.48; 95% CI, 1.48; 95% CI, 1-2.19), admission to the neonatal ICU (RR = 1.54; 95% CI, 1.05-2.25) and small for gestational age status (RR = 1.51; 95% CI, 0.94-2.42) were higher among infants whose mothers had an operation-to-birth interval of less than 2 years compared with those with an operation-to-birth interval of more than 4 years.
“This study underscores the higher risk status of this population and may indicate that a recently postoperative mother with underlying nutritional, metabolic and physiological changes is at an elevated risk for perinatal complications,” the researchers wrote. “These findings could help inform health care professionals and postoperative women of childbearing age about the optimal timing between bariatric surgery and conception.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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