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Bariatric Surgery

Reduction of cardiovascular complications during delivery hospitalization in patients undergoing bariatric procedures

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

Background

The global surge in obesity presents a significant health challenge, leading to increased adoption of bariatric surgery as an intervention. However, the correlation between bariatric surgery and cardiovascular outcomes during subsequent pregnancies remains unclear. The aim of our study was to determine the prevalence of cardiovascular complications during delivery hospitalizations in patients with bariatric procedure.

Methods

We performed a retrospective analysis utilizing the National Inpatient Sample database to examine data from delivery admissions of pregnant women with obesity and a history of bariatric surgery. These admissions were identified using International Classification of Diseases (ICD) codes from 2009 to 2019. In comparing pregnant individuals who had undergone bariatric surgery with those with obesity but had no such surgical history, we assessed the prevalence of cardiovascular complications.

Results

Our study included 3,027,987 pregnancies in individuals with obesity and an additional 117,350 pregnancies following bariatric surgery. Compared to patients without bariatric surgery, post-surgery patients were older (32.84 years vs 29.02 years), primarily White (59.0%), and mostly treated in large urban hospitals. Cardiovascular outcomes showcased reduced odds of congestive heart failure [Adjusted odds ratios (AOR) 0.11, 95% confidence intervals (CI) 0.01–0.74], gestational hypertensive complications (AOR 0.55, 95% CI 0.53–0.59), and cardiac arrhythmia (AOR 0.76, 95% CI 0.64–0.89) in the post-surgery group, with no significant difference in peripartum cardiomyopathy rates (AOR 0.72, 95% CI 0.29–1.76) and no instances of stroke or acute MI. Perinatally, the surgery cohort had higher odds of preterm birth (AOR 1.30, 95% CI 1.24–1.38) and fetal growth restriction (AOR 2.47, 95% CI 2.32–2.63) but fewer incidents of being large for gestational-age (AOR 0.35, 95% CI 0.32–0.38). As bariatric surgery became increasingly recognized as a significant factor in certain complications, its prevalence among the study population increased from 2009 to 2019.

Conclusion

In summary, our research indicates that bariatric surgery is associated with a decreased risk of cardiovascular complications during delivery. This study highlights how insights from bariatric surgery outcomes could shape clinical guidelines for managing obesity in pregnant women.

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Data availability

The data that support the findings of this study are available from the corresponding author, Chengu Niu, upon reasonable request.

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Authors and Affiliations

  1. Internal Medicine Residency Program, Rochester General Hospital, Rochester, NY, 14621, USA

    Chengu Niu, Hina Ukrani & Nagesh Jadhav

  2. Southeast Alaska Regional Health Consortium, Sitka, AK, 99835, USA

    Jing Zhang

  3. Sichuan University, Chengdu, 610000, China

    Yujing Han

  4. Division of Gastroenterology, Rochester General Hospital, Rochester, NY, 14621, USA

    Dilendra Weerasinghe & Patrick I. Okolo

  5. Division of Cardiology, Rochester General Hospital, Rochester, NY, 14621, USA

    Mallory Balmer-Swain

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  1. Chengu Niu
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  7. Nagesh Jadhav
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  8. Patrick I. Okolo
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Contributions

CN: conception and design of the study. JZ, HU, YH, NJ, MB-S: literature search, extraction, analysis and interpretation of data. CN: draft of manuscript. DW, PIO 3rd: revision and approval of manuscript. All authors provided comments, revised the draft, and approved the final version of the article.

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Correspondence to Chengu Niu.

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Niu, C., Zhang, J., Ukrani, H. et al. Reduction of cardiovascular complications during delivery hospitalization in patients undergoing bariatric procedures. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01532-4

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