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. 2016 Dec;26(12):2837-2842.
doi: 10.1007/s11695-016-2202-4.

Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions That Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR)

Eric Edison  1 , Martin Whyte  2 , Jeremy van Vlymen  2 , Simon Jones  2 , Piers Gatenby  2   3 , Simon de Lusignan  2 , Jill Shawe  2
Affiliations

Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions That Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR)

Eric Edison et al. Obes Surg. 2016 Dec.

Abstract

Background: The aims of this study are the following: to describe the female population of reproductive age having bariatric surgery in the UK, to assess the age and ethnicity of women accessing surgery, and to assess the effect of bariatric surgery on factors that underlie fertility and pregnancy outcomes.

Methods: Demographic details, comorbidities, and operative type of women aged 18-45 years were extracted from the National Bariatric Surgery Registry (NBSR). A comparison was made with non-operative cases (aged 18-45 and BMI ≥40 kg/m2) from the Health Survey for England (HSE, 2007-2013). Analyses were performed using "R" software.

Results: Data were extracted on 15,222 women from NBSR and 1073 from HSE. Women aged 18-45 comprised 53 % of operations. Non-Caucasians were under-represented in NBSR compared to HSE (10 vs 16 % respectively, p < 0.0001). The NBSR group was older than the HSE group-median 38 (IQR 32-42) vs 36 (IQR 30-41) years (Wilcoxon test p < 0.0001). Almost one third of women in NBSR had menstrual dysfunction at baseline (33.0 %). BMI fell in the first year postoperatively from 48.2 ± 8.3 to 37.4 ± 7.5 kg/m2 (t test, p < 0.001). From NBSR, in the postoperative period, the prevalence of type 2 diabetes fell by 54 %, polycystic ovarian syndrome by 15 %, and any menstrual dysfunction by 12 %.

Conclusions: Over half of all bariatric procedures are carried out on women of reproductive age. More work is required to provide prompt and equal access across ethnic groups. At least one in three women suffers from menstrual dysfunction at baseline. Bariatric surgery improves factors that underlie fertility and pregnancy outcomes. A prospective study is required to verify these effects.

Keywords: Bariatric surgery; Fertility; Neonatal outcomes; Obesity; Parturition; Preconception care; Pregnancy.

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Conflict of interest statement

Compliance with Ethical Standards Conflicts of Interest The authors declare that they have no conflicts of interest. Statement of Informed Consent Informed consent was obtained from all individual participants included in the study. Statement of Human and Animal Rights All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
Change in BMI based on the month of follow-up. The mean BMI at baseline is shown by dot and error bars at 0 months. The mean BMI recorded at each month of follow-up with error bars. One point per patient is shown on graph
Fig. 2
Fig. 2
Total number of comorbidities before and after operation
Fig. 3
Fig. 3
Relative contribution of each comorbidity before and after operation
See this image and copyright information in PMC

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