Bariatric Surgery Boosts Odds of Preemie BirthsAugust 31, 2016
According to new research from Sweden, women who have undergone weight-loss or bariatric surgery have higher chances of giving birth prematurely.
Dr. Olof Stephansson, lead researcher of the study at Karolinska Institute in Stockholm said, "Women and their doctors should be aware of this risk increase, and women with previous bariatric surgery should be carefully monitored during pregnancy".
The same team conducted an earlier study with a sample of less than 600 women and the results refuted the current findings.
The latest research which evaluated nearly 2000 female weight-loss surgery patients, found that 8.4 percent were preterm- after no more than 37 weeks of gestation. While nearly 6,600 women of the same size who did not have surgery only had 6.8 percent preterm births.
"We cannot say what is causing this risk increase, but we have matched other known risk factors like maternal age, cigarette smoking and parity [number of pregnancies]," Stephansson added.
According to Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City, obese women are more likely to have problems conceiving, and weight-loss surgery, or "bariatric" surgery, "can give them a chance at fertility." She added, "I see many women who can't conceive because of their obesity, and I think that bariatric surgery can give them an opportunity. However, after bariatric surgery a woman's first pregnancy is a high-risk pregnancy."
While the research suggests the likelihood of having a preterm birth after bariatric surgery is still low, past procedures should also be carefully weighed against the risk of obesity during pregnancy.
The results also showed that there is a higher chance of moderately preterm births, between 32 and 37 weeks of gestation after weight-loss surgery, which is 2 percent higher than women who have not had an operation.
No significant relationship with bariatric surgery was established for very preterm birth cases occurring 32 weeks before gestation with only 1 percent of these cases in both groups.
Dr. Mitchell Kramer, chairman of obstetrics and gynecology at Northwell Health's Huntington Hospital in Huntington, N.Y. said, “because bariatric surgery reduces stomach capacity, it's possible that fetuses aren't getting enough nutrients.”
Weight-loss surgery presents a higher risk to pregnancy especially those in later stages. “These patients have to be on supplements and we have to monitor them," Kramer added. Fetal development should be continually checked through fetal monitoring procedures and ultrasounds for an imminent preemie birth. It is also best for women who have undergone bariatric operations to be on top of things by knowing the risk of preterm birth and how to lower it, Kramer said.
Moreover, Dr. Stephansson also acknowledged the benefits of bariatric surgery during pregnancy, which includes a decreased risk of pregnancy complications like gestational diabetes, preeclampsia and large babies.
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