(619) Pregnancy complication and birth outcomes before and after maternal bariatric surgery

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: With worldwide obesity pandemic, bariatric surgeries have become a popular solution in many western countries. This surgery is performed between the ages 35-53, therefore many women during reproductive ages undergo this surgery. The aim of the current study was to compare pregnancy characteristics and complications of women before and after having bariatric surgeries.

Study Design: A retrospective population based study was performed, including all singleton deliveries which occurred at a tertiary medical center between the years 1991-2021. The pregnancies of women who underwent the surgery were included in an analysis comparing pregnancy characteristics and complications before and after the surgery. Multivariable generalized estimation equation (GEE) binary models were used to match between siblings before and after the surgery, and to address confounding variables, including maternal age and smoking.

Results:

The study population included 380,258 deliveries, 3,074 were of women who underwent bariatric surgeries (1,586 deliveries were before and 1,488 after the surgery). The Graph presents main pregnancy complications in the entire study population. Pregnancies of women after the surgery were less likely to be complicated with hypertensive disorders, macrosomia, perinatal mortality, but not gestational diabetes mellitus (GDM), and were more likely to have cesarean delivery (CD) (Table 1). In the multivariable analyses no differences were found between deliveries after vs. before the surgery regarding macrosomia (adj. OR=0.80; 95%CI 0.47-1.35); perinatal mortality (adj. OR=0.26; 95%CI 0.07-1.03); GDM (adj.OR=0.81; 95%CI 0.62-1.05) and hypertensive disorders (adj.OR=0.70; 95%CI 0.41-1.19), and the risk for CD remained significantly higher among deliveries after vs. before bariatric surgeries (adj.OR=1.40; 95%CI 1.04-1.89).

Conclusion: While bariatric surgeries may benefit the mother, it does not seem to lower the risk for the pregnancy and perinatal complications associated with obesity, and it is actually associated with higher risk for cesarean deliveries

Primary & Presenting Author(s)

Tamar Wainstock, PhD (she/her/hers)
Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel, Israel

Coauthor(s)

Eyal Sheiner, MD,PhD
Head of department of Obstetrics and Gynecology B, Soroka University Medical Center
Soroka Medical Center
Omer, HaDarom, Israel