Pregnancy outcome in morbidly obese women before and after laparoscopic gastric banding.
BACKGROUND
Increasing numbers of pregnancies are seen in obese women treated surgically with laparoscopic adjustable gastric banding (LAGB). We compared their maternal and fetal outcomes with obese women without LAGB and normal-weight controls.


METHODS
Sixty-nine obese women with LAGB (83 pregnancies) were compared with 120 obese women without LAGB and 858 controls.


RESULTS
By comparison with normal controls, post-LAGB pregnancies had higher rates of gestational hypertension (9.6% vs 2.4%, p < 0.05), preeclampsia/eclampsia (12.0% vs 2.3%, p < 0.001), abortion (10.8% vs 0.3%, p < 0.001), cesarean section (45.9% vs 28.2%, p < 0.01), preterm delivery (17.6% vs 3.6%, p < 0.001), and babies needing neonatal intensive care (20.3% vs 9.0%, p < 0.01). Compared with the no-LAGB obese group, the post-LAGB pregnancies had lower rates of gestational hypertension (9.6% vs 23.5%, p < 0.05), preeclampsia/eclampsia (12.0% vs 20.8%, p < 0.05), and cesarean section (45.9% vs 65.8%, p < 0.01). The post-LAGB obese women gained less weight during the pregnancy (6.6 +/- 7.9 vs 14.8 +/- 10.1 kg, p < 0.001) and experienced less gestational hypertension (14.8% vs 33%), preeclampsia/eclampsia (7.4% vs 14.8%), and macrosomia (4.2% vs 16%) than in pregnancies before LAGB. No significant differences in maternal and fetal outcomes emerged between post-LAGB pregnant women who lost versus those who gained weight during pregnancy. Compared with those no longer morbidly obese, women still morbidly obese after LAGB had a lower weight gain (2.8 +/- 11.8 vs 8.6 +/- 9.5 kg, p < 0.05) and a higher gestational hypertension rate (29.4% vs 8.9%, p < 0.05).


CONCLUSIONS
The risks of negative maternal and fetal outcomes for obese women can be reduced by LAGB if the women are closely followed up.
Lapolla
Annunziata
A
Department of Medical and Surgical Sciences, University of Padova, Via Giustiniani n 2, 35100, Padova, Italy. annunziata.lapolla@unipd.it
Marangon
Mariangela
M
Dalfrà
Maria Grazia
MG
Segato
Gianni
G
De Luca
Maurizio
M
Fedele
Domenico
D
Favretti
Franco
F
Enzi
Giuliano
G
Busetto
Luca
L
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005260:Female; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011256:Pregnancy Outcome; D015430:Weight Gain; D055815:Young Adult