Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass
Presented at the 24th Annual Meeting of the American Society for Bariatric Surgery, June 11–16, 2007, San Diego, California
Received 11 May 2007; received in revised form 15 October 2007; accepted 18 October 2007.
Abstract
Background
Early reports described adverse perinatal outcomes of pregnancies after weight loss surgery (WLS), which subsequently raised concerns regarding safety. Our objective was to investigate, in a community-based, academic, tertiary care center, the safety of pregnancies after laparoscopic Roux-en-Y gastric bypass (LRYGB) and its potential effect on obesity-related perinatal complications.
Methods
The pregnancy outcomes of patients delivering infants after LRYGB at our institution were compared with those of control subjects (stratified by body mass index) who had not undergone WLS. The charts were retrospectively reviewed for demographics, delivery route, and perinatal complications.
Results
A total of 26 patients who delivered after LRYGB and 254 controls were identified. The mean interval from LRYGB to conception was 25.4 ± 13.0 months. In general, the perinatal complications in the LRYGB patients were similar to those in the nonobese controls and lower than in the obese and severe obese controls, although statistical significance was not noted for all complications. No spontaneous abortions or stillbirths occurred in the LRYGB patients. No LRYGB patients required intravenous nutrition or hydration. The overall incidence of cesarean section in the LRYGB patients was similar to that in the obese and severely obese controls but significantly greater than that in the nonobese controls. The complication rates were similar in pregnancies occurring “early” (<12 mo) versus “late” (>18 mo) after LRYGB.
Conclusion
The results of our study have shown that pregnancy after LRYGB is safe, with an incidence of perinatal complications similar to that of nonobese patients, and lower than that of obese and severely obese patients, who had not undergone WLS. Larger studies are required to demonstrate statistically significant improvements in outcome in patients treated with WLS.
aDepartment of Surgery, Division of Bariatric Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania
bDepartment of Surgery, University of Texas Health Science Center, San Antonio, Texas
cDepartment of Obstetrics and Gynecology, Allegheny General Hospital, Pittsburgh, Pennsylvania
ABSTRACT