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Association of prenatal substance use disorders with pregnancy and birth outcomes following bariatric surgery

International Journal of Obesity volume 46, pages 107–112 (2022)Cite this article

Subjects

Abstract

Background/Objectives

While an increased risk for substance use disorders (SUD) and also for several adverse pregnancy and birth outcomes in patients who have undergone bariatric surgery have been well documented when considered separately, an association between these important risk factors has not been investigated. This study explored the potential dependence of these two bariatric surgery-related risks.

Subjects/Methods

This study was a retrospective cohort study with adult women (18–45) who underwent bariatric surgery between 1996 and 2016 and who gave birth after surgery between 1996 and 2018. The study population consisted of 1849 post-bariatric surgery women with 3010 reported post-surgical births. Subjects with post-surgical, prenatal SUD were identified based on diagnosis codes extracted within the 10 months prior to delivery. Using random-effects logistic regression with retrospective cohort data, preterm birth, low birth weight, macrosomia, Caesarian delivery, congenital anomalies, and neonatal intensive care unit admission were considered as outcomes.

Results

About 10% (n = 289) of women had an SUD diagnosis within 10 months prior to child delivery. Women with SUD during pregnancy had significantly more pregnancy and birth complications compared to women without SUD: preterm birth (OR = 2.08, p = 0.03, 95% CI: 1.07–4.03), low birth weight (OR = 3.41, p < 0.01, 95% CI: 1.99–5.84), Caesarian delivery (OR = 9.71, p < 0.01, 95% CI: 2.69–35.05), and neonatal intensive care unit admission (OR = 3.87, p < 0.01, 95% CI: 2.04–7.34). Women with SUD had lower risk for macrosomia than women without SUD (OR = 0.07, p = 0.02, 95% CI: 0.01–0.70).

Conclusion

Results from this study demonstrated that post-bariatric surgery women who had SUD during pregnancy had significantly more pregnancy- and birth-related complications than post-surgery pregnant women without SUD, despite the reduction in macrosomia. Where possible, greater prenatal surveillance of post-surgery women with SUD should be considered.

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Funding

Partial support for all datasets within the Utah Population Database was provided by the University of Utah Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support grant (grant number P30 CA2014) from the National Cancer Institute.

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Authors and Affiliations

  1. Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT, USA

    Jaewhan Kim

  2. Department of Exercise Sciences, Brigham Young University, 271 SFH, Provo, UT, USA

    Lance Davidson

  3. Department of Genetic Medicine Weill Cornell Medicine-Qatar Education City Qatar Foundation, PO Box 24144, Doha, Qatar

    Steven Hunt

  4. Intermountain Health Care, 5300 South State Street, Murray, UT, USA

    Nathan Richards

  5. Division of Epidemiology, University of Utah, 295 Chipeta Way, Salt Lake City, UT, USA

    Ted Adams

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  1. Jaewhan Kim
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Contributions

JK and TA had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JK. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: JK and TA. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: JK and SH. Administrative, technical, or material support: JK, TA, and LD. Supervision: JK and TA.

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Correspondence to Jaewhan Kim.

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Kim, J., Davidson, L., Hunt, S. et al. Association of prenatal substance use disorders with pregnancy and birth outcomes following bariatric surgery. Int J Obes 46, 107–112 (2022). https://doi.org/10.1038/s41366-021-00964-6

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