Impact of Surgery-to-Conception Interval on Maternal and Perinatal Outcomes Following Laparoscopic Sleeve Gastrectomy: A Retrospective Cohort Study
摘要
Severe obesity is a major global health concern. The majority of patients undergoing bariatric surgery are women of reproductive age. Current international guidelines recommend contraception during the first 12–18 months following bariatric surgery; however, the available evidence remains heterogeneous. The aim of this study was to evaluate the maternal and fetal effects of the interval time between laparoscopic sleeve gastrectomy and conception.
MethodsPregnant women with a history of laparoscopic sleeve gastrectomy (LSG) were retrospectively evaluated. Patients were categorized into three groups according to the surgery-to-conception interval. Group 1 consisted of early pregnancies (interval time < 12 months), Group 2 of intermediate pregnancies (interval time 12–18 months), and Group 3 of late pregnancies (interval time > 18 months). Maternal outcomes included preeclampsia, gestational diabetes mellitus, gestational hypertension, and anemia. Fetal outcomes included small for gestational age (SGA), congenital anomalies, preterm birth, and neonatal intensive care unit (NICU) admission.
ResultsA total of 72 patients were included in the study, comprising 13 patients in the early pregnancy group, 20 in the intermediate pregnancy group, and 39 in the late pregnancy group. No significant differences were observed among the groups regarding maternal outcomes, including preeclampsia, gestational hypertension, gestational diabetes mellitus, anemia, hyperemesis gravidarum, and type of delivery. Evaluation of fetal outcomes demonstrated higher rates of SGA and preterm birth in the early pregnancy group, whereas no significant difference was found among the groups with respect to NICU admission.
ConclusionIn our study, the interval between bariatric surgery and conception was not associated with maternal outcomes. However, conception within 12 months after surgery was associated with an increased risk of SGA and preterm birth. These findings should be interpreted with caution, and women who conceive following bariatric surgery should be closely monitored by a multidisciplinary team.