Pregnant Obese Women: Bariatric Surgery Before Pregnancy Lowers Risks Of Complication

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A study published on bmj.com today reports that obese women who undergo bariatric surgery before having a baby have a much lower risk of developing serious health problems during pregnancy.

Findings indicated that women who delivered after surgery had substantially lower rates (75 percent) of hypertensive disorders compared with women who delivered before surgery.

Hypertensive disorders during gestation are a common cause of pregnancy complications and infant death. They affect about 7 percent of all pregnancies in the United States. Obesity, particularly extreme obesity, is a risk factor for hypertensive disorders in expectant mothers. These include serious conditions such as pre-eclampsia, where abnormally high blood pressure and other disturbances develop during pregnancy.

Bariatric surgery is an effective weight loss intervention for women with a body mass index (BMI) of 40 or more, or a BMI of 35 to 40 with associated conditions like diabetes. However, the impact of surgery on hypertensive disorders in pregnancy is unclear.

In order to find out more, researchers from Johns Hopkins University in the United States set out to test the theory. Did women who had a delivery after bariatric surgery have lower rates of hypertensive disorders in pregnancy compared with women who had a delivery before surgery?

Using insurance data from 2002-2006, they identified 585 obese women aged 16 to 45 years who had undergone bariatric surgery. These women had at least one pregnancy and delivery. They also had continuous medical insurance coverage during pregnancy plus two weeks after delivery.

Of these women, 269 had surgery before delivery and 316 had surgery after delivery.

Findings indicated that women who delivered after surgery had substantially lower rates (75 percent) of hypertensive disorders compared with women who delivered before surgery. This was true even after adjusting for factors such as age at delivery, multiple pregnancy, surgical procedure, pre-existing diabetes, and insurance plan.

The authors note that these results have important clinical, public health, and policy implications. For instance, bariatric surgery could be considered in women of childbearing age who wish to start a family, and have a BMI of 40 or more, or a BMI of 35 to 40 with associated conditions.

They write in closing that future research should also concentrate on long term maternal and child health after pregnancies and deliveries following bariatric surgery. Weight management, nutritional status, and burden of long term chronic disease should be considered.

From research study published April 2010 -- Impact of bariatric surgery on hypertensive disorders in pregnancy: retrospective analysis of insurance claims data Wendy L Bennett, assistant professor, Marta M Gilson, assistant professor, Roxanne Jamshidi, assistant professor, Anne E Burke, assistant professor, Jodi B Segal, associate professor, Kimberley E Steele, assistant professor, Martin A Makary, associate professor, Jeanne M Clark, associate professor

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Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Hypertension Also referred to as high blood pressure, HTH, HTN or HPN, hypertension is a medical condition in which the blood pressure is chronically elevated. In current usage, the word "hypertension" without a qualifier normally refers to arterial hypertension. The Mayo Clinic specifies blood pressure is "normal if it's below 120/80".

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Diabetes Mellitus A disease that occurs when the body is not able to use blood glucose (sugar). Blood sugar levels are controlled by insulin, a hormone in the body that helps move glucose from the blood to muscles and other tissues. Diabetes occurs when the pancreas does not make enough insulin or the body does not respond to the insulin that is made. There are two main types of diabetes mellitus: Type 1 Diabetes and Type 2 Diabetes. All forms of diabetes have been treatable since insulin became medically available in 1921, but there is no cure.