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Non‐obstetric surgery during gestation: Risk factors for lower birthweight
Author(s) -
Jenkins Thomas M.,
Mackey Suzanne F.,
Benzoni Elisa M.,
Tolosa Jorge E.,
Sciscione Anthony C.
Publication year - 2003
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1046/j.0004-8666.2003.00001.x
Subject(s) - gestation , obstetrics , medicine , pregnancy , biology , genetics
Abstract Objective: To assess the risk for preterm birth and low birthweight for women undergoing non‐obstetric surgery during gestation. Design: Two perinatal tertiary care centres. Population: Women undergoing non‐obstetric surgery during gestation between January 1989 and June 1999. Materials and methods: A chart review was carried out. Cervical cerclages, procedures carried out under local anaesthesia or intravenous sedation, or carried out in combination with Caesarean delivery were excluded. Main outcome measures: Preterm birth (<37 weeks), birthweight. Results: A total of 116 of 69 800 women (0.2%) underwent non‐obstetric surgery, with 96 women delivering under our care. Procedures were more commonly carried out in the second trimester (53%), versus the first (23%) or third trimester (24%). Surgery in the second trimester resulted in the lowest rate of preterm birth (11%). The overall preterm birth rate was 21% (20/96), with 13 out of 20 (65%) occurring between 35 and 37 weeks. The mean interval from surgery to delivery was 18.7 weeks. Rates of preterm birth were similar for either intra‐ versus extra‐abdominal procedures, or general versus regional anaesthetic. Use of a general anaesthetic was associated with a significant decrease in birthweight (3053 vs 3515 g, P = 0.01) despite similar gestational ages at delivery (37.6 vs 38.6 weeks, P = 0.08). Multiple linear regression controlled for gestational age showed that general anaesthesia, longer surgery duration, and intra‐abdominal procedures were all significant independent risk factors for lower birthweight. Conclusion: While non‐obstetric surgery appears to be relatively safe during gestation, general anaesthesia, longer surgery time, and intra‐abdominal procedures are associated with lower birthweights.