The Increasing Possibility of Pregnancy Postbariatric Surgery: a Comprehensive National Cohort Study in Asian Population
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ORIGINAL CONTRIBUTIONS
The Increasing Possibility of Pregnancy Postbariatric Surgery: a Comprehensive National Cohort Study in Asian Population Meng-Fan Hsieh 1,2 & Jian-Han Chen 2,3,4,5
&
Yu-Chieh Su 5,6 & Chung-Yen Chen 3,4,5 & Cheng-Hung Lee 7,8
Received: 26 August 2020 / Revised: 27 October 2020 / Accepted: 29 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The present study aimed to investigate bariatric surgery’s effects on pregnancy in obese women. Materials and Methods The source of the data was the Taiwan National Health Insurance Research Database. We extracted female patients aged 18 to 45 years who had been diagnosed with obesity from 2005 to 2010. Two groups were formed based on bariatric surgery, according to the medical procedure codes of ICD-9-2001. The propensity score match of 1:1 was coordinated, based on the age, previous delivery, and the existence of comorbidities in patients. The primary endpoint was regarded as a pregnancy, including abortion, ectopic pregnancy, and delivery. The follow-up was performed until the end of 2013, or death. Results There were 689 patients placed in each group, with a median of 64.8 follow-up months. Following multivariate analysis of the data, bariatric surgery resulted in significantly higher chances for pregnancy (aHR 2.886, p < 0.001) and resulted in a higher chance of successful delivery (aHR 2.775, p < 0.001) and vaginal delivery (aHR = 6.426, p < 0.001) compared with NS group. Moreover, we identified BS has a significantly higher proportion of vaginal delivery (BS 44.74% vs. NS 20%, p = 0.025) with significantly lower overall complications during labor (BS 9.21% vs. NS 33.3%, p = 0.006). Conclusion Patients suffering from obesity who undergo bariatric surgery have higher chances of pregnancy, successful delivery, vaginal delivery, and lower maternal complications during labor. Bariatric surgery did increase the possibility of pregnancy in obese patients. Keywords Fertility . Bariatric surgery . Obesity . Pregnancy . Delivery . BMI
Cheng-Hung Lee contributed equally as Corresponding author. * Jian-Han Chen [email protected] 1
Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
2
E-DA Healthcare Group Department of Medical Education, Kaohsiung, Taiwan
3
Bariatric and Metabolic Surgery Center, E-Da Hospital, Kaohsiung, Taiwan
4
Division of General Surgery, E-Da Hospital, No. 1, Yida Rd., Yanchao Dist., Kaohsiung City 824, Taiwan, Republic of China
5
School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
6
Division of Hematology-Oncology, EDa Hospital, Kaohsiung, Taiwan
7
Department of General Surgery, Buddhist Dalin Tzu Chi Hospital, Chia-Yi, Taiwan
8
School of Medicine, Tzu Chi University, Hualien, Taiwan
Introduction Both obesity and being overweight wield detrimental influences on several human biological functions, including reproductive health [1]. In the preconception period, it has been proved that obesity is associated with reduced fertility. It i
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