663: Perinatal outcomes after bariatric surgery

Abstract

ObjectiveObesity remains a significant public health problem that results in increased risk of adverse perinatal outcomes. Although a growing number of women are becoming pregnant after bariatric surgery, few studies have assessed its impact on perinatal outcomes. We therefore examined the association between bariatric surgery and risk of adverse perinatal outcomes in a large cohort of pregnant women.Study DesignA retrospective cohort study of women who delivered at ≥20 weeks of gestation (n=154,275) in Kaiser Permanente Southern California (KPSC) hospitals (2006-2010) was performed using the Perinatal Service System, the KPSC Bariatric Surgery Registry, Hospital Inpatient, and Outpatient physician encounter records. ICD-9 codes from hospitalizations during pregnancy and infant birth certificates records were used to ascertain the exposure and outcomes of interest. Adjusted odds ratio (OR) and 95% confidence interval (CI) were used to quantify the associations.ResultsBariatric surgery was associated with increased risk of surgical site infection (OR 2.5, 95% CI 1.2, 5.3) and gestational anemia (OR 2.2, 95% CI 1.6, 3.2). Bariatric surgery was not associated with preeclampsia, placental abruption, previa, chorioamnionitis, gestational diabetes, fetal distress, spontaneous and medically-indicated preterm births, large for gestational age births, respiratory distress syndrome, or neonatal sepsis.ConclusionThe results suggest that bariatric surgery may be associated with selected adverse perinatal outcomes. Women with bariatric surgery before pregnancy may benefit from additional intrapartum/postpartum care to reduce infections and targeted nutritional intervention. ObjectiveObesity remains a significant public health problem that results in increased risk of adverse perinatal outcomes. Although a growing number of women are becoming pregnant after bariatric surgery, few studies have assessed its impact on perinatal outcomes. We therefore examined the association between bariatric surgery and risk of adverse perinatal outcomes in a large cohort of pregnant women. Obesity remains a significant public health problem that results in increased risk of adverse perinatal outcomes. Although a growing number of women are becoming pregnant after bariatric surgery, few studies have assessed its impact on perinatal outcomes. We therefore examined the association between bariatric surgery and risk of adverse perinatal outcomes in a large cohort of pregnant women. Study DesignA retrospective cohort study of women who delivered at ≥20 weeks of gestation (n=154,275) in Kaiser Permanente Southern California (KPSC) hospitals (2006-2010) was performed using the Perinatal Service System, the KPSC Bariatric Surgery Registry, Hospital Inpatient, and Outpatient physician encounter records. ICD-9 codes from hospitalizations during pregnancy and infant birth certificates records were used to ascertain the exposure and outcomes of interest. Adjusted odds ratio (OR) and 95% confidence interval (CI) were used to quantify the associations. A retrospective cohort study of women who delivered at ≥20 weeks of gestation (n=154,275) in Kaiser Permanente Southern California (KPSC) hospitals (2006-2010) was performed using the Perinatal Service System, the KPSC Bariatric Surgery Registry, Hospital Inpatient, and Outpatient physician encounter records. ICD-9 codes from hospitalizations during pregnancy and infant birth certificates records were used to ascertain the exposure and outcomes of interest. Adjusted odds ratio (OR) and 95% confidence interval (CI) were used to quantify the associations. ResultsBariatric surgery was associated with increased risk of surgical site infection (OR 2.5, 95% CI 1.2, 5.3) and gestational anemia (OR 2.2, 95% CI 1.6, 3.2). Bariatric surgery was not associated with preeclampsia, placental abruption, previa, chorioamnionitis, gestational diabetes, fetal distress, spontaneous and medically-indicated preterm births, large for gestational age births, respiratory distress syndrome, or neonatal sepsis. Bariatric surgery was associated with increased risk of surgical site infection (OR 2.5, 95% CI 1.2, 5.3) and gestational anemia (OR 2.2, 95% CI 1.6, 3.2). Bariatric surgery was not associated with preeclampsia, placental abruption, previa, chorioamnionitis, gestational diabetes, fetal distress, spontaneous and medically-indicated preterm births, large for gestational age births, respiratory distress syndrome, or neonatal sepsis. ConclusionThe results suggest that bariatric surgery may be associated with selected adverse perinatal outcomes. Women with bariatric surgery before pregnancy may benefit from additional intrapartum/postpartum care to reduce infections and targeted nutritional intervention. The results suggest that bariatric surgery may be associated with selected adverse perinatal outcomes. Women with bariatric surgery before pregnancy may benefit from additional intrapartum/postpartum care to reduce infections and targeted nutritional intervention.