Effect of Successful Bariatric Surgery on Maternal Cardiovascular Outcomes

Abstract

Background:

Obesity is a common comorbidity among women of childbearing age. With increasing obesity, more females are considering bariatric surgery (BS) as a form of weight loss. The effect of successful bariatric surgery (sBS) on maternal cardiovascular outcomes remains to be elucidated.

Methods:

Patients were extracted from the National Inpatient Sample database. We mainly stratified patients into two groups—BS candidates and sBS. We matched patients by age, race, and cardiovascular risk factors using propensity-score matching. The primary outcome was a composite and defined as major adverse cardiovascular events (MACE). Secondary outcomes included preeclampsia, gestational diabetes, and extended length of hospital stay (eLOS). The study also evaluated two other groups of interest—patients that had BS with outcomes other than success (oBS) and any patient with a history of BS.

Results:

Of 5,892 patients with BS, 2,966 patients had sBS. 115,490 patients were BS candidates. BS candidate patients had increased MACE relative to sBS patients. Additionally, they had higher rates of preeclampsia, gestational diabetes, and eLOS relative to BS candidate patients, even after matching. oBS patients also had decreased rates of MACE, heart failure, preeclampsia, gestational diabetes, and eLOS compared with BS candidates after matching. Lastly, to further demonstrate the beneficial effects of BS, patients with a history of BS had similar outcomes, including improved MACE, compared with patients without BS.

Conclusion:

sBS was associated with a reduction in MACE. The significant reduction in MACE highlights the importance of considering BS as an option if conventional weight loss measures fail.