Highlights
- •Evaluation of maternal and neonatal outcomes of women with morbid obesity who delivered before BS as compared to their counterparts who delivered after BS.
- •Diabetes mellitus, found in 67% of the women who delivered before BS. Multivariate analysis of the data comparing the before and after bariatric groups. Specifically, different in age between the 2 groups which imply correlation and not causation.
- •Women who delivered before BS compared to women who delivered after BS had higher rates of anemia, gestational diabetes, and preeclampsia.
- •Women with deliveries before BS were characterized by higher birth weight in the neonates, more cases of premature membrane rupture, and relatively high number of SGAs.
Abstract
Background
Obesity is associated with short term perinatal risks, causing increased risks in
pre- and post-term birth, small and large for gestational (SGA/LGA), congenital anomalies,
and perinatal mortality.
Objective
This study evaluate maternal and neonatal outcomes of women with morbid obesity who
delivered before BS as compared to their counterparts who delivered after BS.
Design
A retrospective analysis in a single institute.
Settings
We use the data according to the ICD-9 code and were extracted from hospital archive.
Patients
Patients were divided int0 two groups consisted of those of who conceived after BS
and those who conceived before BS.
Interventions
All women who underwent any BS and retrieved their obstetric files before or after
the surgery.
Main outcomes measures
The pregnancy, delivery data and obstetric factors were collected, clinical variables,
background data and surgical bariatric procedures, operating time, length of hospital
stay.
Results
149 morbidly obese women, of which 45 delivered after BS (group I) and 104 delivered
prior to BS (group II). The most frequent comorbidity was diabetes mellitus, found
in 67% of the women who delivered before BS. Time to delivery was longer in the women
before BS, (P = 0.015) for the after BS group. Women who delivered before BS compared
to women who delivered after BS had higher rates of anemia (p = 0.038), gestational
diabetes (p = 0.064), and preeclampsia (p = 0.043). Women with deliveries before BS
were characterized by higher birth weight in the neonates, (p < 0.001), more cases
of premature membrane rupture, (14%, p < 0.018) and relatively high number of SGAs.
A multivariate analysis of the data imply correlation to age and not causation.
Limitations
This study was a small retrospective study and selection bias can occur which may
reduce the accuracy of the results.
Conclusions
There are clear health benefits of weight loss for morbidly obese women of reproductive
age, and BS has an important role to play in this population.
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Article info
Publication history
Published online: August 06, 2022
Accepted:
July 20,
2022
Received in revised form:
June 24,
2022
Received:
December 23,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.