title: Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women.
abstract: OBJECTIVE
  Pregnancies among morbidly obese women are associated with serious adverse maternal and neonatal outcomes. Our study objective is to evaluate the effect of bariatric surgery on obstetrical outcomes.
  
  
  METHODS
  We carried out a retrospective cohort study using the healthcare cost and utilization project - Nationwide Inpatient Sample from 2003 to 2011 comparing outcome of births among women who had undergone bariatric surgery with births among women with morbid obesity. Logistic regression was used to estimate the adjusted effect of bariatric surgery on maternal and newborn outcomes.
  
  
  RESULTS
  There were 8 475 831 births during the study period (221 580 (2.6%) in morbidly obese women and 9587 (0.1%) in women with bariatric surgery). Women with bariatric surgery were more likely to be Caucasian and ≥35 years old as compared with morbidly obese women. As compared with women with morbid obesity, women with bariatric surgery had lower rates of hypertensive disorders, premature rupture of membrane, chorioamnionitis, cesarean delivery, instrumental delivery, postpartum hemorrhage, and postpartum infection. Induction of labor, postpartum blood transfusions, venous thromboembolisms, and intrauterine fetal growth restriction were more common in the bariatric surgery group. There were no differences observed in preterm births, fetal deaths, or reported congenital anomalies.
  
  
  CONCLUSIONS
  In general, women who undergo bariatric surgery have improved pregnancy outcomes as compared with morbidly obese women. However, the bariatric surgery group was more likely to have venous thromboembolisms, to require a blood transfusion, to have their labor induced and to experience fetal growth restriction.
authors.affiliation: a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Quebec , Canada and.|b Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital , Montreal , Quebec , Canada.
authors.forename: Haim A
authors.initials: HA
authors.lastname: Abenhaim
authors.affiliation: a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Quebec , Canada and.
authors.forename: Nouf
authors.initials: N
authors.lastname: Alrowaily
authors.affiliation: b Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital , Montreal , Quebec , Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Czuzoj-Shulman
authors.affiliation: b Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital , Montreal , Quebec , Canada.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Spence
authors.affiliation: a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , Quebec , Canada and.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Klam
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D000013:Congenital Abnormalities / Q000209:etiology; D016208:Databases, Factual; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D009767:Obesity, Morbid / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Bariatric surgery; obesity; obstetrical outcomes; pregnancy