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

Background: Obesity 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. Objective: This study evaluate maternal and neonatal outcomes of women with morbid obesity who delivered before BS as compared to their counterparts who delivered after BS. Design: A retrospective analysis in a single institute. Settings: We use the data according to the ICD-9 code and were extracted from hospital archive. Patients: Patients were divided int0 two groups consisted of those of who conceived after BS and those who conceived before BS. Interventions: All women who underwent any BS and retrieved their obstetric files before or after the surgery. Main outcomes measures: The pregnancy, delivery data and obstetric factors were collected, clinical variables, background data and surgical bariatric procedures, operating time, length of hospital stay. Results: 149 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. Limitations: This study was a small retrospective study and selection bias can occur which may reduce the accuracy of the results. Conclusions: There 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.