Perinatal Outcome After Bariatric Surgery

Abstract

IntroductionBariatric surgery is increasingly performed in individuals of reproductive age to treat obesity and reduce associated comorbidities. However, the impact of these procedures on subsequent pregnancy outcomes remains incompletely understood. This study evaluates perinatal outcomes in patients with a history of bariatric surgery, focusing exclusively on pregnancies occurring after surgery, using a large, real-world database.MethodsA retrospective cohort study was conducted using the TriNetX Research Network, a national, de-identified electronic health record database. We identified pregnant females aged ≥18 between June 1, 2015, and June 25, 2025. Patients with prior bariatric surgery were identified using ICD-10 and CPT codes. Propensity score matching (1:1) was performed based on age, race, ethnicity, gravida, parity, hypertension, diabetes, anemia, and delivery method, yielding 41 777 matched pairs. Perinatal outcomes including fetal growth restriction (FGR), macrosomia, gestational hypertension, gestational diabetes, preeclampsia, and preterm delivery were compared using odds ratios (ORs) and 95% confidence intervals (CIs).ResultsBariatric surgery was associated with significantly lower risks of FGR (OR 0.831, 95% CI 0.749-0.921), macrosomia (OR 0.283, 95% CI 0.262-0.305), gestational hypertension (OR 0.391, 95% CI 0.375-0.409), preeclampsia (OR 0.313, 95% CI 0.294-0.334), gestational diabetes (OR 0.415, 95% CI 0.393-0.439), and preterm delivery (OR 0.525, 95% CI 0.493-0.560) compared to controls.ConclusionPatients with a history of bariatric surgery who became pregnant after the procedure experienced significantly reduced risks of several adverse perinatal outcomes. These findings support the role of bariatric surgery in improving pregnancy outcomes among individuals with obesity and underscore the importance of preconception counseling and tailored prenatal care.

Keywords: adverse outcomes; bariatric surgery; gastrointestinal surgery; obesity; perinatal outcomes; plastic surgery.