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Publications

Journal Article Ppublish

PubMed: 40032752 DOI: 10.1007/s11695-025-07762-3

Impact of Prior Bariatric Surgery on Labor and Delivery-Related Outcomes: A Nationwide Study.

Obes Surg 35(4):1387-1395

Authors: Bhanu Siva Mohan Pinnam, Pius Ehiremen Ojemolon, Shahroz Fatima, Marwan S Abougergi, Violeta Popov

Affiliations

  • John H. Stroger Jr. Hospital of Cook County, Chicago, USA.
  • Emory University Hospital, Atlanta, USA.
  • NYU Langone Health, New York City, NY, USA.
  • INOVA Health, Falls Church, USA.
  • NYU Langone Health, VA New York Harbor Health Care System, New York City, NY, USA.

Abstract

BACKGROUND

Limited literature exists on labor and delivery outcomes after bariatric surgery. This study assesses the impact of prior bariatric surgery on peripartum outcomes.

METHODS

We queried the National Inpatient Sample (2016-2020) for labor and delivery admissions, categorizing them into three cohorts: prior bariatric surgery (BaS), obesity without prior bariatric surgery, and controls without obesity. We used a multivariate regression model, adjusting for confounders, to compare peripartum outcomes.

RESULTS

We identified 22,685 BaS cases, 2.1 million pregnant controls with obesity, and 16.37 million pregnant controls without obesity. Compared to controls with obesity, the BaS cohort had lower rates of cesarean delivery [43% vs 46.8%, adjusted odds ratio (aOR) 0.72, p < 0.001], fetal distress [aOR 0.79, p < 0.001), post-partum hemorrhage (aOR 0.67, p < 0.001), fetal disproportion (aOR 0.36, p < 0.001), and premature rupture of membranes (aOR 0.88, p = 0.04). Compared to controls without obesity, the BaS group had higher rates of cesarean delivery (43% vs 29.57%, aOR 1.43, p < 0.001), breech presentation (aOR 1.4, p < 0.001), thromboembolic events (aOR 2.47, p = 0.01), and pregnancy termination (aOR 1.59, p = 0.048), but lower rates of assisted delivery (aOR 0.54, p < 0.001), fetal disproportion (aOR 0.56, p = 0.025), PROM (aOR 0.87, p = 0.024), and placenta previa (aOR 0.63, p = 0.019). The BaS group had longer hospitalizations (3.11 vs 2.56 days, p < 0.001) and higher hospitalization charges (25,941 vs 20,760, p < 0.001) compared to controls without obesity.

CONCLUSION

Pregnancy after bariatric surgery is associated with lower odds of cesarean delivery and postpartum complications, relative to the general population with obesity. This underscores the positive impact of bariatric surgery on peripartum outcomes.

MeSH

Hospitalization, Bariatric Surgery, Obesity, Peripartum Period