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Risk of Abdominal Surgery in Pregnancy Among Women Who Have Undergone Bariatric Surgery

Stuart, Andrea LU and Källen, Karin LU (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.

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author
organization
publishing date
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
  • 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
2018-05-20 04:33:33
@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},
  volume       = {129},
  year         = {2017},
}