Counseling, contraception, and conception rates in patients undergoing bariatric surgery: A retrospective review

To determine conception rates, contraceptive use patterns, and frequency of counseling regarding pregnancy recommendations in patients undergoing bariatric surgery. Using a database of bariatric surgery patients at our institution, we identified female patients aged 18 to 45 who underwent surgery fr...

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Bibliographic Details
Published in:	Contraception (Stoneham) 2021-08, Vol.104 (2), p.202-205
Main Authors:	Thornton, Olivia, Daggett, Emily, Zia, Lyba, Quian, Anna, Close, Emma, Khaitan, Leena, El-Nashar, Sherif A., Shaker, Maria
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Bariatric Surgery Contraception Contraceptive counseling Contraceptives, Oral Counseling Female Humans Intrauterine Devices LARC Middle Aged Pregnancy Retrospective Studies Weight loss surgery Young Adult
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Summary:	To determine conception rates, contraceptive use patterns, and frequency of counseling regarding pregnancy recommendations in patients undergoing bariatric surgery. Using a database of bariatric surgery patients at our institution, we identified female patients aged 18 to 45 who underwent surgery from 2013 to 2018. Patient charts were reviewed for demographic information, documentation of counseling regarding pregnancy recommendations, conception during the postoperative period, and pre and postoperative contraception use. We examined rates of contraception use and used standard statistical tests to compare conception rates between groups. Of the 460 patients that met inclusion criteria and did not have a history of permanent contraception, 54% (95% CI 49–58) had documented postoperative contraception use, most commonly the levonorgestrel-releasing intrauterine device followed by combination oral contraceptive pills. In the 18 months following bariatric surgery, 6% of patients (95% CI 4–8) had a documented pregnancy. Over 50% (95% CI 35–71) of pregnancies occurred in patients without documented postoperative contraception. For bariatric surgery patients at risk of pregnancy, postoperative contraception use patterns and conception rates are not consistent with the recommendation to refrain from pregnancy for 18 months. Individualized contraceptive counseling that includes a discussion of fertility and weight loss goals, planned bariatric procedure type, and patient preference should be implemented as part of standard preoperative care for patients at risk of pregnancy undergoing bariatric surgery.
ISSN:	0010-7824 1879-0518