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单吻合口胃旁路术后的妊娠结局

Pregnancy Outcomes After One Anastomosis Gastric Bypass.

作者信息

Rottenstreich Amihai, Elazary Ram, Ben-Porat Tair, Sherf-Dagan Shiri, Beglaibter Nahum, Grinbaum Ronit

机构信息

Department of Obstetrics & Gynecology, Edith Wolfson Medical Center, Holon, Israel.

Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

出版信息

Obes Surg. 2025 Jun 24. doi: 10.1007/s11695-025-08006-0.

Abstract

BACKGROUND

One anastomosis gastric bypass (OAGB) is gaining increasing acceptance worldwide. Pregnancy outcomes after OAGB have been understudied. We aimed to examine associations of OAGB with maternal and perinatal outcomes.

METHODS

The study group comprised women who delivered after OAGB during 2017-2024 in a university hospital. A control group was established by matching preoperative body mass index, age, delivery history, and delivery year.

RESULTS

Overall, 50 OAGB and 50 matched control parturients were included. In the OAGB group, rates of gestational hypertensive disorders (2.0% vs. 10.0%, P = 0.008) and gestational diabetes mellitus (4.0% vs. 18.0%, P = 0.05) were significantly lower compared with the control group. For the OAGB group, hemoglobin levels were lower at both early pregnancy (11.5 vs. 13.1 g/dL, P < 0.001) and pre-delivery (10.4 vs. 10.9 g/dL, P = 0.008), with a higher proportion of patients requiring intravenous iron supplementation (24.0% vs. 2.0%, P = 0.002). Rate of induction of labor was lower within the OAGB group (12.5% vs. 36.1%, P = 0.03), while gestational age at delivery and mode of delivery were similar between the groups. For the OAGB group, birthweight was significantly lower (2900 vs. 3392 grams, P < 0.001) with a higher proportion of small-for-gestational-age infants (28.0% vs. 6.0%, P = 0.006) and a lower proportion of large-for-gestational-age infants (2.0% vs. 24.0%, P = 0.002).

CONCLUSIONS

OAGB was associated with reduced rates of gestational diabetes mellitus, gestational hypertensive disorders, excessive fetal growth, and induction of labor; and an increased rate of small-for-gestational-age infants. Hemoglobin levels were lower throughout pregnancy among OAGB patients, with a higher incidence of intravenous iron supplementation.

摘要

背景

单吻合口胃旁路术(OAGB)在全球范围内越来越被广泛接受。OAGB术后的妊娠结局尚未得到充分研究。我们旨在研究OAGB与孕产妇及围产期结局之间的关联。

方法

研究组包括2017年至2024年期间在一所大学医院接受OAGB术后分娩的女性。通过匹配术前体重指数、年龄、分娩史和分娩年份建立对照组。

结果

总体而言,纳入了50例接受OAGB手术的产妇和50例匹配的对照产妇。在OAGB组中,妊娠期高血压疾病的发生率(2.0%对10.0%,P = 0.008)和妊娠期糖尿病的发生率(4.0%对18.0%,P = 0.05)显著低于对照组。对于OAGB组,妊娠早期(11.5对13.1 g/dL,P < 0.001)和分娩前(10.4对10.9 g/dL,P = 0.008)的血红蛋白水平均较低,需要静脉补充铁剂的患者比例更高(24.0%对2.0%,P = 0.002)。OAGB组的引产率较低(12.5%对36.1%,P = 0.03),而两组之间的分娩孕周和分娩方式相似。对于OAGB组,出生体重显著较低(2900对3392克,P < 0.001),小于胎龄儿的比例较高(28.0%对6.0%,P = 0.006),大于胎龄儿的比例较低(2.0%对24.0%,P = 0.002)。

结论

OAGB与妊娠期糖尿病、妊娠期高血压疾病、胎儿过度生长和引产率降低相关;与小于胎龄儿的发生率增加相关。OAGB患者在整个孕期的血红蛋白水平较低,静脉补充铁剂的发生率较高。

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