Maternal and neonatal outcome of women before vs. after bariatric surgery: A single tertiary center experience

Abstract

BackgroundObesity 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. ObjectiveThis study evaluate maternal and neonatal outcomes of women with morbid obesity who delivered before BS as compared to their counterparts who delivered after BS. DesignA retrospective analysis in a single institute. SettingsWe use the data according to the ICD-9 code and were extracted from hospital archive. PatientsPatients were divided int0 two groups consisted of those of who conceived after BS and those who conceived before BS. InterventionsAll women who underwent any BS and retrieved their obstetric files before or after the surgery. Main outcomes measuresThe pregnancy, delivery data and obstetric factors were collected, clinical variables, background data and surgical bariatric procedures, operating time, length of hospital stay. Results149 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. LimitationsThis study was a small retrospective study and selection bias can occur which may reduce the accuracy of the results. ConclusionsThere 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.