Obstetrical and neonatal outcomes in women following gastric bypass: a Danish national cohort study

TY - JOUR

T1 - Obstetrical and neonatal outcomes in women following gastric bypass

T2 - a Danish national cohort study

AU - Berlac, Janne Foss

AU - Skovlund, Charlotte Wessel

AU - Lidegaard, Ojvind

N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

PY - 2014/5

Y1 - 2014/5

N2 - OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population.DESIGN: Historical controlled cohort study.SETTING: Denmark.POPULATION: All women undergoing gastric bypass during the period 1996-2011, and subsequently giving birth.METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women.RESULTS: In 415 women giving birth after gastric bypass we found significantly more women with hypertension in pregnancy; relative risk (RR) 2.5 (95% confidence interval 1.3-5.0), gestational diabetes; RR = 6.9 (3.5-13.5), and acute abdominal pain during pregnancy; RR = 4.7 (2.9-7.8) compared with normal weight controls. Compared with women with similar body mass index, they had a lower incidence of preeclampsia and emergency cesarean sections, and their children a lower incidence of asphyxia; RR = 0.4 (0.2-0.8). Their children were on average 212 g smaller than newborn of normal weight mothers, and 319 g smaller than newborn of adipose controls, and had significantly more admissions to neonatal intensive care unit compared with newborn of normal weight mothers; RR = 1.5 (1.1-2.0).CONCLUSIONS: Gastric bypass may reduce the risk of preeclampsia, emergency cesarean section, and perinatal asphyxia, compared with adipose women without surgery. Compared with normal weight controls women who had had a gastric bypass had a higher risk of hypertension, gestational diabetes, and acute abdominal pain during pregnancy and their children a lower birthweight and higher incidence of admittance to neonatal intensive care.

AB - OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population.DESIGN: Historical controlled cohort study.SETTING: Denmark.POPULATION: All women undergoing gastric bypass during the period 1996-2011, and subsequently giving birth.METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women.RESULTS: In 415 women giving birth after gastric bypass we found significantly more women with hypertension in pregnancy; relative risk (RR) 2.5 (95% confidence interval 1.3-5.0), gestational diabetes; RR = 6.9 (3.5-13.5), and acute abdominal pain during pregnancy; RR = 4.7 (2.9-7.8) compared with normal weight controls. Compared with women with similar body mass index, they had a lower incidence of preeclampsia and emergency cesarean sections, and their children a lower incidence of asphyxia; RR = 0.4 (0.2-0.8). Their children were on average 212 g smaller than newborn of normal weight mothers, and 319 g smaller than newborn of adipose controls, and had significantly more admissions to neonatal intensive care unit compared with newborn of normal weight mothers; RR = 1.5 (1.1-2.0).CONCLUSIONS: Gastric bypass may reduce the risk of preeclampsia, emergency cesarean section, and perinatal asphyxia, compared with adipose women without surgery. Compared with normal weight controls women who had had a gastric bypass had a higher risk of hypertension, gestational diabetes, and acute abdominal pain during pregnancy and their children a lower birthweight and higher incidence of admittance to neonatal intensive care.

KW - Abdominal Pain

KW - Adolescent

KW - Adult

KW - Asphyxia Neonatorum

KW - Body Mass Index

KW - Case-Control Studies

KW - Cesarean Section

KW - Cohort Studies

KW - Denmark

KW - Diabetes, Gestational

KW - Female

KW - Gastric Bypass

KW - Humans

KW - Hypertension, Pregnancy-Induced

KW - Incidence

KW - Infant, Newborn

KW - Infant, Small for Gestational Age

KW - Middle Aged

KW - Obesity

KW - Pre-Eclampsia

KW - Pregnancy

KW - Pregnancy Complications

KW - Pregnancy Outcome

KW - Registries

KW - Young Adult

U2 - 10.1111/aogs.12368

DO - 10.1111/aogs.12368

M3 - Journal article

C2 - 24592873

SN - 0001-6349

VL - 93

SP - 447

EP - 453

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 5

ER -