Does Bariatric Surgery Affect the Risk of Adverse Outcomes in Pregnancy?

From Medscape General Surgery > Viewpoints

Albert B. Lowenfels, MD

Posted: 08/16/2010

Impact of Bariatric Surgery on Hypertensive Disorders in Pregnancy: Retrospective Analysis of Insurance Claims Data

Bennett WL, Gilson MM, Jamshidi R, et al

BMJ. 2010;340:c1662

Summary

Does bariatric surgery lower the risk of an adverse outcome during pregnancy? The authors used administrative claims data from 7 large US insurance plans to look at adverse pregnancy outcomes in relation to surgery for morbid obesity. Gastric bypass was the most common procedure performed. Among the 585 study participants, 269 patients delivered before undergoing bariatric surgery, compared with 316 patients who delivered after having surgery. Pre-eclampsia was much less frequent in the group of patients who had previously undergone bariatric surgery (odds ratio 0.20; 95% confidence interval 0.09-0.44). Additionally, the risk of any hypertensive disorder was lower in patients who delivered after bariatric surgery (odds ratio 0.25; 95% confidence interval 0.15-0.40).

Viewpoint

This was an observational study rather than a randomized trial. Nevertheless, in the group of women who became pregnant after obesity surgery, the risk of eclampsia or any hypertensive adverse outcome was much lower than in the women who did not have prior obesity surgery. Because data on body mass index were not available, we can only assume that the two groups of patients were similar with respect to height and weight. The data support the benefits of obesity surgery for female patients in the child-bearing age group. It is also possible that obesity surgery might reduce the frequency of Cesarean sections, although such data were not included in the study.



Abstract

Authors and Disclosures

Albert B. Lowenfels, MD

Professor of Surgery, Professor of Community Preventive Medicine, New York Medical College, Valhalla, New York; Emeritus Surgeon, Department of Surgery, Westchester Medical Center, Valhalla, New York Disclosure: Albert B. Lowenfels, MD, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: Solvay Pharmaceuticals, Inc.