Risk of Abdominal Surgery in Pregnancy Among Women Who Have Undergone Bariatric Surgery
(2017) In Obstetrics and Gynecology 129(5). p.887-895- Abstract
OBJECTIVE:: To compare the rates of abdominal surgery during pregnancy among women with previous bariatric surgery (women in the case group) and women with first-trimester body mass index (BMI) greater than 35 and no previous bariatric surgery (women in the control group). METHODS:: We conducted a national cohort study, merging data from the Swedish Medical Birth Registry and the Swedish National Patient Registry, comparing women who had bariatric surgery from 1987 to 2011 with women in a control group with first-trimester BMI greater than 35 who had not had bariatric surgery. Primary outcome variables were diagnosis and surgical procedure codes grouped as five outcome categories: 1) intestinal obstruction, 2) gallbladder disease, 3)... (More)
OBJECTIVE:: To compare the rates of abdominal surgery during pregnancy among women with previous bariatric surgery (women in the case group) and women with first-trimester body mass index (BMI) greater than 35 and no previous bariatric surgery (women in the control group). METHODS:: We conducted a national cohort study, merging data from the Swedish Medical Birth Registry and the Swedish National Patient Registry, comparing women who had bariatric surgery from 1987 to 2011 with women in a control group with first-trimester BMI greater than 35 who had not had bariatric surgery. Primary outcome variables were diagnosis and surgical procedure codes grouped as five outcome categories: 1) intestinal obstruction, 2) gallbladder disease, 3) appendicitis, 4) hernia, and 5) diagnostic laparoscopy or laparotomy without the presence of a diagnosis or surgical code for outcomes in outcome categories 1–4. Odds ratios were computed using multivariate linear regression analysis for each separate pregnancy. For all pregnancies in a given woman, general estimating equations with robust variance estimation were used. Adjustment was made for smoking, year of delivery, maternal age, and previous abdominal surgery. RESULTS:: During the first pregnancy after bariatric surgery, the rate of surgery for intestinal obstruction was 1.5% (39/2,543; 95% confidence interval [CI] 1.1–2.0%) in women in the case group compared with 0.02% (4/21,909; 95% CI 0.0–0.04%) among women in the control group (adjusted odds ratio [OR] 34.3, 95% CI 11.9–98.7). Similarly, the rate of diagnostic laparoscopy or laparotomy was 1.5% (37/2,542; 95% CI 1.0–1.9%) among women in the case group compared with 0.1% (18/21,909; 95% CI 0.0–0.1%) among women in the control group (adjusted OR 11.3, 95% CI 6.9–18.5). CONCLUSION:: Bariatric surgery is associated with an increased risk of abdominal surgery during pregnancy.
(Less)
- author
- Stuart, Andrea LU and Källen, Karin LU
- organization
- publishing date
- 2017-04-04
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Obstetrics and Gynecology
- volume
- 129
- issue
- 5
- pages
- 887 - 895
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:85017101135
- pmid:28383368
- wos:000402113100019
- ISSN
- 0029-7844
- DOI
- 10.1097/AOG.0000000000001975
- language
- English
- LU publication?
- yes
- id
- 88df4c95-5278-4d54-b095-9a16ceb468a0
- date added to LUP
- 2017-05-08 13:14:41
- date last changed
- 2025-01-07 12:41:25
@article{88df4c95-5278-4d54-b095-9a16ceb468a0,
abstract = {{<p>OBJECTIVE:: To compare the rates of abdominal surgery during pregnancy among women with previous bariatric surgery (women in the case group) and women with first-trimester body mass index (BMI) greater than 35 and no previous bariatric surgery (women in the control group). METHODS:: We conducted a national cohort study, merging data from the Swedish Medical Birth Registry and the Swedish National Patient Registry, comparing women who had bariatric surgery from 1987 to 2011 with women in a control group with first-trimester BMI greater than 35 who had not had bariatric surgery. Primary outcome variables were diagnosis and surgical procedure codes grouped as five outcome categories: 1) intestinal obstruction, 2) gallbladder disease, 3) appendicitis, 4) hernia, and 5) diagnostic laparoscopy or laparotomy without the presence of a diagnosis or surgical code for outcomes in outcome categories 1–4. Odds ratios were computed using multivariate linear regression analysis for each separate pregnancy. For all pregnancies in a given woman, general estimating equations with robust variance estimation were used. Adjustment was made for smoking, year of delivery, maternal age, and previous abdominal surgery. RESULTS:: During the first pregnancy after bariatric surgery, the rate of surgery for intestinal obstruction was 1.5% (39/2,543; 95% confidence interval [CI] 1.1–2.0%) in women in the case group compared with 0.02% (4/21,909; 95% CI 0.0–0.04%) among women in the control group (adjusted odds ratio [OR] 34.3, 95% CI 11.9–98.7). Similarly, the rate of diagnostic laparoscopy or laparotomy was 1.5% (37/2,542; 95% CI 1.0–1.9%) among women in the case group compared with 0.1% (18/21,909; 95% CI 0.0–0.1%) among women in the control group (adjusted OR 11.3, 95% CI 6.9–18.5). CONCLUSION:: Bariatric surgery is associated with an increased risk of abdominal surgery during pregnancy.</p>}},
author = {{Stuart, Andrea and Källen, Karin}},
issn = {{0029-7844}},
language = {{eng}},
month = {{04}},
number = {{5}},
pages = {{887--895}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Obstetrics and Gynecology}},
title = {{Risk of Abdominal Surgery in Pregnancy Among Women Who Have Undergone Bariatric Surgery}},
url = {{http://dx.doi.org/10.1097/AOG.0000000000001975}},
doi = {{10.1097/AOG.0000000000001975}},
volume = {{129}},
year = {{2017}},
}