Obese women who undergo surgery first may reduce risk of hypertensive disorders in later pregnancy
WEDNESDAY, April 14 (HealthDay News) -- Obese women who undergo bariatric surgery before having a baby have a lower risk of hypertensive disorders in pregnancy than obese women who have a baby before undergoing bariatric surgery, according to a retrospective cohort study published online April 13 in BMJ.
Wendy L. Bennett, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated claims data for 2002 to 2006 from seven insurance plans in the United States that included 585 women, 16 to 45 years of age, who had undergone bariatric surgery, had at least one pregnancy and delivery, and had continuous insurance coverage during pregnancy plus two weeks after delivery.
The researchers found that women who delivered a baby before bariatric surgery were typically younger at the time of delivery but had higher rates of pre-existing and gestational diabetes. After adjustment for age at delivery, multiple pregnancy (twins or more), surgical procedure, pre-existing diabetes and insurance plan, women who delivered after the surgery had lower rates of preeclampsia and eclampsia, chronic hypertension complicating pregnancy and gestational hypertension, compared to women who delivered before the surgery. Overall, women who delivered after surgery had much lower rates of hypertensive disorders (75 percent) in pregnancy than women who delivered before surgery.
"Our findings support the use of bariatric surgery in women of childbearing age who meet eligibility criteria for surgery, either class III obesity or class II obesity with high-risk comorbidities, to potentially decrease the rates of hypertensive disorders in pregnancy and associated complications," the authors write.
Funding provided by unrestricted research grants from Ethicon Endo-Surgery, Pfizer and GlaxoSmithKline.
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