title: Bariatric surgery and associated adverse pregnancy outcomes among obese women.
abstract: OBJECTIVE
  To evaluate whether bariatric surgery is associated with intrauterine growth restriction (IUGR).
  
  
  METHODS
  We performed a population-based retrospective cohort study to estimate the relationship between prior bariatric surgery and adverse pregnancy outcomes. The data were collected from the 2012 Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS). Pregnancies in obese women with a prior bariatric surgery were compared to those of obese women without. Outcomes of interest were pre-eclampsia, IUGR, intrauterine fetal demise, large for gestational age, postpartum hemorrhage, failed induction of labor, cesarean delivery and operative vaginal delivery. Multivariable logistic regression analysis was used to adjust for potential confounders.
  
  
  RESULTS
  186,605 obese women with singleton gestations were identified. Among these, 1585 (0.8%) women had a prior bariatric surgery. Prior bariatric surgery was associated with an increased risk of IUGR (5.7% versus 2.2%, adjusted odds ratio 2.89, 99% CI 1.55-5.39, p < 0.0001) even after adjusting for confounding factors. No differences were seen in our other outcomes of interest.
  
  
  CONCLUSIONS
  Singleton gestations in obese women with a prior bariatric surgery have an increased risk of IUGR. It may be reasonable screen these pregnancies for the development of growth restriction.
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine at Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Meiling Hua
authors.initials: MH
authors.lastname: Parker
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine at Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.affiliation: a Department of Obstetrics and Gynecology , Sidney Kimmel College of Medicine at Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Jugnu Biba
authors.initials: JB
authors.lastname: Nijjar
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies
keywords: Bariatric surgery; IUGR; gastric bypass; intrauterine growth restriction; pregnancy; small for gestational age