Pregnancy After Bariatric Surgery in Women with Rheumatic Diseases and Association with Adverse Birth Outcomes

Namrata Singh¹, Rebecca Baer², Maya Swaminathan³, Shireesh Saurabh⁴, Jeffrey Sparks⁵, Gretchen Bandoli⁶, Elena Flowers⁷, Laura Jelliffe-Pawlowski² and Kelli Ryckman⁸, ¹University of Washington, Bellevue, WA, ²University of California San Francisco, San Francisco, ³University of Washington, Seattle, WA, ⁴Kaiser Permanente WA, Bellevue, WA, ⁵Brigham and Women's Hospital, Boston, MA, ⁶University of California San Diego, La Jolla, CA, ⁷UCSF, San Francisco, CA, ⁸University of Iowa, Iowa City

Meeting: ACR Convergence 2020

Keywords: pregnancy, rheumatoid arthritis, surgery

Session Information

Date: Monday, November 9, 2020

Title: Reproductive Issues in Rheumatic Disorders Poster

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose: Autoimmune rheumatic diseases (ARD) and bariatric surgery are each risk factors for adverse birth outcomes. To date, no study has investigated their combined impact on birth outcomes. The objective of this study was to evaluate the impact of bariatric surgery on pregnancy in patients with ARD with and without bariatric surgery.

Methods: This retrospective cohort study included infants born between 20–44 weeks of gestation in California between 2011–2018. Birth certificates were linked to maternal and infant hospital and emergency department discharge records. History of maternal bariatric surgery and ARD was identified from discharge records. We compared combinations of ARD and bariatric surgery to women with an ARD and no bariatric surgery for adverse maternal and infant outcomes.

Results: The study included 3,574,165 pregnancies, of whom 10,823 (0.3%) had an ARD and 8,172 (0.22%) of the total women had a history of bariatric surgery. There were 86 women (0.0022%) with both an ARD and a history of bariatric surgery. Among women with bariatric surgery and no ARD, the incidence of preterm birth was 13.9%. Among women with ARD and no bariatric surgery it was 18%. Among women with both an ARD and a history of bariatric surgery the incidence was 19.8%. Women with a history of bariatric surgery and an ARD had similar risk of having a preterm birth, small for gestational age or large for gestational age infant, or a cesarean delivery compared to women with an ARD and no history of bariatric surgery (Table 1). Over 20% of infants born to women with a history of ARD and bariatric surgery were admitted to the NICU compared to 13.0% of infants born to those with an ARD and no history of bariatric surgery (adjusted relative risk, aRR, 1.7, 95% CI 1.1 to 2.8).

Conclusion: Our study shows that women with ARD already have a high occurrence of several adverse birth outcomes, and this was not further increased by a history of bariatric surgery. The infants born to women with a history of ARD and bariatric surgery were admitted to the NICU significantly more than the infants born to women with an ARD and no history of bariatric surgery.

Disclosure: N. Singh, Rheumatology Research Foundation, 2, American Heart Association, 2; R. Baer, None; M. Swaminathan, None; S. Saurabh, None; J. Sparks, Amgen, 1, Bristol-Myers Squibb, 1, 2, Gilead, 1, Inova, 1, Janssen, 1, Optum, 1; G. Bandoli, None; E. Flowers, None; L. Jelliffe-Pawlowski, None; K. Ryckman, None.

To cite this abstract in AMA style:

Singh N, Baer R, Swaminathan M, Saurabh S, Sparks J, Bandoli G, Flowers E, Jelliffe-Pawlowski L, Ryckman K. Pregnancy After Bariatric Surgery in Women with Rheumatic Diseases and Association with Adverse Birth Outcomes [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/pregnancy-after-bariatric-surgery-in-women-with-rheumatic-diseases-and-association-with-adverse-birth-outcomes/. Accessed .

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/pregnancy-after-bariatric-surgery-in-women-with-rheumatic-diseases-and-association-with-adverse-birth-outcomes/