PDF(Pubmed)
Abstract：
BACKGROUND: Metabolic bariatric surgery (MBS) is known to improve the obstetric outcomes of women with obesity and to prevent gestational diabetes (GD). To what extent does MBS decreases GD, without incurring at additional risks is a matter of concern.
METHODS: A retrospective case-control study to compare the pregnancy outcomes of women previously submitted to MBS to those of age and preconception body mass index (PC BMI) matched non-operated controls.
RESULTS: Pregnancies of women after MBS (n = 79) and matched controls (n = 79) were included. GD was significantly less frequent after MBS (7.6% vs. 19%; p = 0.03). Fasting blood glucose (76.90 ± 0.77 vs 80.37 ± 1.15 mg/dl, p < 0.05; 70.08 ± 1.34 vs. 76.35 ± 0.95 mg/dl; p < 0.05, first and second trimesters respectively) and birth weight (2953.67 ± 489.51 g vs. 3229.11 ± 476.21 g; p < 0.01) were significantly lower after MBS when compared to controls. The occurrence of small-for-gestational-age (SGA) was more frequent after MBS (22.8% vs. 6.3%; p < 0.01), but no longer significant after controlling for smoking habits (15.5% vs. 6%, p = 0.14). There were no significant differences in gestational weight gain, prematurity rate nor mode of delivery between groups.
CONCLUSIONS: MBS was associated with a lower prevalence of GD than observed in non-operated women with the same age and BMI. After controlling for smoking, this occurred at the expense of a lower birth weight. Our data reinforces the hypothesis that MBS has body weight independent effects on glucose kinetics during pregnancy with distinctive impacts for mother and offspring, which need to be balanced.
METHODS: A retrospective case-control study to compare the pregnancy outcomes of women previously submitted to MBS to those of age and preconception body mass index (PC BMI) matched non-operated controls.
RESULTS: Pregnancies of women after MBS (n = 79) and matched controls (n = 79) were included. GD was significantly less frequent after MBS (7.6% vs. 19%; p = 0.03). Fasting blood glucose (76.90 ± 0.77 vs 80.37 ± 1.15 mg/dl, p < 0.05; 70.08 ± 1.34 vs. 76.35 ± 0.95 mg/dl; p < 0.05, first and second trimesters respectively) and birth weight (2953.67 ± 489.51 g vs. 3229.11 ± 476.21 g; p < 0.01) were significantly lower after MBS when compared to controls. The occurrence of small-for-gestational-age (SGA) was more frequent after MBS (22.8% vs. 6.3%; p < 0.01), but no longer significant after controlling for smoking habits (15.5% vs. 6%, p = 0.14). There were no significant differences in gestational weight gain, prematurity rate nor mode of delivery between groups.
CONCLUSIONS: MBS was associated with a lower prevalence of GD than observed in non-operated women with the same age and BMI. After controlling for smoking, this occurred at the expense of a lower birth weight. Our data reinforces the hypothesis that MBS has body weight independent effects on glucose kinetics during pregnancy with distinctive impacts for mother and offspring, which need to be balanced.
摘要：
背景：已知代谢减肥手术（MBS）可以改善肥胖妇女的产科结局并预防妊娠期糖尿病（GD）。MBS在多大程度上降低GD，在不产生额外风险的情况下，这是一个令人担忧的问题。
方法：一项回顾性病例对照研究，目的是比较先前接受MBS的妇女的妊娠结局与年龄和孕前体重指数（PCBMI）匹配的非手术对照组的妊娠结局。
结果：包括MBS后的孕妇（n=79）和匹配的对照组（n=79）。MBS后GD明显减少（7.6%与19%；p=0.03）。空腹血糖（76.90±0.77vs80.37±1.15mg/dl，p<0.05;70.08±1.34vs.76.35±0.95mg/dl；p<0.05，分别为孕早期和中期）和出生体重（2953.67±489.51gvs.与对照组相比，MBS后3229.11±476.21g；p<0.01）显着降低。MBS后小于胎龄（SGA）的发生率更高（22.8%vs.6.3%；p<0.01)，但在控制吸烟习惯后不再显著(15.5%vs.6%,p=0.14）。妊娠体重增加没有显着差异，两组之间的早产率和分娩方式。
结论：与年龄和BMI相同的非手术女性相比，MBS与GD的患病率较低相关。控制吸烟后，这是以降低出生体重为代价的。我们的数据强化了以下假设：MBS在怀孕期间对葡萄糖动力学具有独立于体重的影响，对母亲和后代具有独特的影响。这需要平衡。
方法：一项回顾性病例对照研究，目的是比较先前接受MBS的妇女的妊娠结局与年龄和孕前体重指数（PCBMI）匹配的非手术对照组的妊娠结局。
结果：包括MBS后的孕妇（n=79）和匹配的对照组（n=79）。MBS后GD明显减少（7.6%与19%；p=0.03）。空腹血糖（76.90±0.77vs80.37±1.15mg/dl，p<0.05;70.08±1.34vs.76.35±0.95mg/dl；p<0.05，分别为孕早期和中期）和出生体重（2953.67±489.51gvs.与对照组相比，MBS后3229.11±476.21g；p<0.01）显着降低。MBS后小于胎龄（SGA）的发生率更高（22.8%vs.6.3%；p<0.01)，但在控制吸烟习惯后不再显著(15.5%vs.6%,p=0.14）。妊娠体重增加没有显着差异，两组之间的早产率和分娩方式。
结论：与年龄和BMI相同的非手术女性相比，MBS与GD的患病率较低相关。控制吸烟后，这是以降低出生体重为代价的。我们的数据强化了以下假设：MBS在怀孕期间对葡萄糖动力学具有独立于体重的影响，对母亲和后代具有独特的影响。这需要平衡。
