Appendicectomy during pregnancy and the risk of preterm birth: A population data linkage study

Ibiebele, Ibinabo; Schnitzler, Margaret; Nippita, Tanya A.; Ford, Jane B.

doi:10.1111/ajo.12807

Cited by 21 publications

(43 citation statements)

References 25 publications

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“…As the operation in itself is unlikely to affect the risk of SGA immediately after surgery, we included a 14‐day lag‐time period, which likely explains why we found a less strong association with SGA. Ibiebele et al showed an equal risk of SGA in laparoscopy and laparotomy, confirming that it is acceptable to combine these procedures when studying the risk of SGA. As in most other studies, we found an increased risk of miscarriage following surgical procedures during pregnancy.…”

Section: Discussionmentioning

confidence: 93%

“…Surgical procedures trigger both inflammatory and microbial responses, which may affect the fetus and timing of birth . The risk of adverse birth outcomes after surgery during pregnancy has been the topic of several studies . A systematic review of the literature until 2002 including 54 studies and 4473 women concluded that non‐obstetric surgery was probably not a risk factor for miscarriage .…”

Section: Introductionmentioning

confidence: 99%

“…Still, the authors underscored a need for better data and well‐designed studies in this area . At least 5 larger studies have since then examined non‐obstetric surgery during pregnancy . In general, these studies found an increased risk of adverse pregnancy outcomes, but Balinskaite et al concluded that the attributable risk was low .…”

Section: Introductionmentioning

confidence: 99%

“…In general, these studies found an increased risk of adverse pregnancy outcomes, but Balinskaite et al concluded that the attributable risk was low . Only Ibiebele et al took gestational age (GA) at time of surgery into account in their analyses and found an increased risk of preterm birth . We have access to Danish nationwide data from a 20‐year period and can contribute with information regarding adverse birth outcomes after non‐obstetric abdominal surgery during pregnancy in a population‐based setting.…”

Section: Introductionmentioning

confidence: 99%

“…12 At least 5 larger studies have since then examined non-obstetric surgery during pregnancy. [10][11][12][13][14] In general, these studies found an increased risk of adverse pregnancy outcomes, but Balinskaite et al concluded that the attributable risk was low. 12 Only Ibiebele et al took gestational age (GA) at time of surgery into account in their analyses and found an increased risk of preterm birth.…”

mentioning

confidence: 99%

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Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Rasmussen

Christiansen

Ulrichsen

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Surgery during pregnancy may increase the risk of adverse birth outcomes. In this nationwide registry‐based cohort study including women aged 15‐54 years with singleton birth or miscarriage, we examined the association between non‐obstetric abdominal surgery during pregnancy and the birth outcomes small‐for‐gestational‐age (SGA), preterm birth, and miscarriage. Material and methods The study used data on births or miscarriages from the large national Danish registries in 1997‐2015. We calculated absolute risks and risk differences for the main outcomes and used Cox regression analysis with non‐obstetric abdominal surgery as a time‐varying exposure, adjusting for maternal age, year of last menstrual period, major abdominal surgery before pregnancy, maternal smoking status, rheumatoid arthritis, diabetes and inflammatory bowel disease. Our main outcome measures were risks and hazard ratios (HRs) for SGA, very preterm or preterm birth, and miscarriage after gestational week 7 overall, stratified by calendar year, and, for SGA, trimester of pregnancy. Finally, absolute risk of miscarriage stratified by time since surgery. Results Absolute risks in surgically treated vs untreated were 3.4% vs 2.7% for SGA (adjusted HR 1.3, 95% CI 1.1‐1.5), 2.2% vs 0.8% for very preterm birth (adjusted HR 2.8, 95% CI 2.2‐3.5), 8.3% vs 4.3% for preterm birth (adjusted HR 2.1, 95% CI 1.9‐2.3), and 8.2% vs 6.1% for miscarriage (adjusted HR 3.1, 95% CI 2.7‐3.5). For miscarriage, the risk was highest the first week after surgery and levelled out after 2 weeks. Conclusions Surgery during pregnancy is associated with an increased risk of SGA, very preterm birth, preterm birth and miscarriage, and the risk of miscarriage is highest the first week after surgery.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Rasmussen

Christiansen

Ulrichsen

et al. 2019

Acta Obstet Gynecol Scand

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Preexistent chronic disorders, often indirectly affecting pregnancy

Peeters¹,

Leeuw²,

Uiterweer³

2021

Pathophysiology of Pregnancy Complications

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Appendectomy in Third Trimester of Pregnancy and Birth Outcomes: A Propensity Score Analysis of a 6‐Year Cohort Study Using Administrative Claims Data

et al. 2019

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Introduction While there is evidence of obstetric and neonatal outcomes from non‐obstetric surgery during pregnancy, surgery during the third trimester of gestation has not been evaluated as a prognostic factor for those outcomes. The objective of this study was to determine whether appendectomies during the third trimester are associated with adverse neonatal outcomes, in comparison with appendectomies during the first two trimesters, based on national administrative data in Colombia. Methods A retrospective cohort study was performed using administrative health records. It included all women who had live births and who underwent an appendectomy during any stage of pregnancy, between the years 2011 and 2016, and who belonged to Colombia's contributory health system. The main outcome was preterm birth. Birth weight and 1‐min and 5‐min Apgar scores were also measured, as well as outcomes used to identify neonatal near‐miss cases. Propensity score matching was used in order to balance baseline characteristics (age, weeks of gestation, obstetric comorbidity index, and region and year the procedure was performed). Relative risks were estimated with Poisson regressions. Results This study included a total of 2507 women in Colombia's contributory health system who underwent an appendectomy during pregnancy. Appendectomy was performed on 885 women (35.30%) in their first trimester, 1205 women (48.07%) in their second trimester, and 417 women (16.63%) in their third trimester. For the entire population, the preterm birth rate was 11.85 per 100 appendectomies. With the matched sample, this study found that women in their third trimester had a 1.65 greater risk of preterm birth [95% CI, 1.118–2.423], a 3.43 greater risk of birth at gestational ages < 33 weeks [95% CI, 1.363 to 8.625], 2.083 greater risk of weight under 1750 g [95% CI, 1.056–4.109], and a mean difference of − 0.247 [95% CI, − .382 to − .112] in the 1‐min Apgar score and − .168a [95% CI, − .276 to − .060] in the 5‐min Apgar. No differences were found in birth weight or Apgar scores < 7. Conclusions In Colombia's contributory health system, women who undergo appendectomies in their third trimester have a greater risk of preterm birth, birth weight under 1750 g, birth at gestational ages less than 33 weeks, and decreased 1‐min and 5‐min Apgar scores.

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Appendicectomy during pregnancy and the risk of preterm birth: A population data linkage study

Cited by 21 publications

References 25 publications

Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Preexistent chronic disorders, often indirectly affecting pregnancy

Appendectomy in Third Trimester of Pregnancy and Birth Outcomes: A Propensity Score Analysis of a 6‐Year Cohort Study Using Administrative Claims Data

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