Mengesha BM, et al. - Researchers aimed at determining the prevalence of perioperative contraceptive and pregnancy interval discussions among women who have recently undergone bariatric surgery. They also described postoperative contraceptive use within the first year of surgery in this population. They noted that a substantial proportion of women who had undergone bariatric surgery had no perioperative pregnancy or contraception counseling, and many women who had felt the discussions were insufficient. Those who had had perioperative discussions more frequently used contraception postoperatively. They recommended perioperative routine counseling of reproductive-aged women about pregnancy and contraception in the context of their reproductive desires, so they can make informed decisions about perioperative pregnancy prevention and contraceptive method use.

Methods

• A cross-sectional study of US women (aged 18-45 years and recruited through Facebook) who underwent bariatric surgery within the last 24 months was performed.

Results

• Three hundred and sixty three geographically-diverse women were enrolled.
• Perioperative pregnancy or contraceptive discussions were reported by three-quarters, the majority of these were with a bariatric provider.
• In this study, half felt it was “very important” to discuss these issues perioperatively, and 41% of those who reported discussions wished they had had more.
• Contraception use was reported in 66% of women in the first 12 months postoperatively; of these, 27% used oral contraceptives and 26% used an intrauterine device.
• Oral contraceptive use was noted in one-third of contraceptive users who had undergone Roux-en-Y gastric bypass, a combined restrictive-malabsorptive procedure.
• Perioperative contraceptive or pregnancy discussions were observed to have an independent association with increased postoperative contraceptive use (OR 2.5, 95% CI 1.5-4.3, P<0.001).