Reproductive health of women electing bariatric surgery

Abstract

Objective: To describe the reproductive health history and characteristics of women having bariatric surgery and to determine whether this differs by age of onset of obesity.

Design: Retrospective and cross-sectional analyses of self-reported survey data.

Setting: Six sites of the Longitudinal Assessment of Bariatric Surgery-2 study.

Patient(s): The study included 1,538 females having bariatric surgery.

Intervention(s): None.

Main outcome measure(s): Reported polycystic ovary syndrome (PCOS), pregnancy and fertility history, contraceptive use, and plans for pregnancies.

Result(s): Mean age was 44.8 years (range, 18-78 years); mean body mass index was 47.2 kg/m2 (range, 33.8-87.3 kg/m2). PCOS had been diagnosed by a health care provider in 13.1% of subjects. Of women who had tried to conceive, 41.9% experienced infertility and 61.4% had a live birth after experiencing infertility. In the whole group, prior live birth was reported by 72.5%. Women who were obese by 18 years old were more likely to report PCOS and infertility and less likely to have ever been pregnant, compared with women who became obese later in life. Future pregnancy was important to 30.3% of women younger than 45 years, whereas 48.6% did not plan to become pregnant in the future. In the year before surgery, 51.8% used contraception.

Conclusion(s): Self-reporting of obesity by age 18 appears to be related to reproductive morbidity. Women undergoing bariatric surgery have important reproductive health care needs, including reliable contraception and counseling about plans for postoperative pregnancy.