The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes-A Case-Control Study.

Introduction: Obesity in pregnant women increases the incidence of pregnancy-induced comorbidities and the rate of operative deliveries. Purpose of the Study: As bariatric surgery is the reference method of treatment of obesity, we wanted to evaluate its influence on the course of pregnancy and perinatal outcomes. Material and Methods: Data was collected from 627 female patients after bariatric surgery, of whom 107 had a history of pregnancy after the surgery, and 345 non-bariatric patients who had a delivery at a tertiary perinatal center. Sixty-one cases were matched (1:1) with controls for age, pre-pregnancy BMI and presence of pre-pregnancy comorbidities. The main endpoints were gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), small (SGA) and large for gestational age infants (LGA) and cesarean sections (CS). Results: Patients after bariatric procedures were significantly less likely to have GDM (19.67%/37.7%; p = 0.0433), PIH (11.47%/16.39%; p = 0.6072) and preterm delivery (13.11%/37.7%; p = 0.0026). The CS rate was higher (57.38%/40.98%; p = 0.0987). There was an increased risk of SGA (18.03%/13.11%; p = 0.6072) and a decreased risk of LGA (6.56%/16.39%; p = 0.146). Conclusions: Patients after bariatric surgery have a decreased risk of pregnancy-induced comorbidities, preterm deliveries and LGA infants, with an increase in rate of CS and SGA infants compared to general population matched for pre-pregnancy BMI, age and presence of pre-pregnancy comorbidities.