akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2024.485akusherstvo-1967Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫThe impact of bariatric surgery on female reproductive healthВлияние бариатрической хирургии на репродуктивное здоровье женщинhttps://orcid.org/0009-0008-0580-5541ЧигишеваЭ. Х.ChigishevaE. Kh.

Элина Халиловна Чигишева, ассистент

450008; ул. Ленина, д. 3; Уфа

Elina Kh. Chigisheva, MD, Assistant

450008; 3 Lenin Str.; Ufa

neurosurg@bk.ruhttps://orcid.org/0009-0008-8703-0507БатыршинИ. И.BatyrshinI. I.

Ильнур Ильдусович Батыршин, ассистент

450008; ул. Ленина, д. 3; Уфа

Ilnur I. Batyrshin, MD, Assistant

450008; 3 Lenin Str.; Ufa

https://orcid.org/0000-0003-4147-0992СарвалиеваА. Ф.SarvalievaA. F.

Алина Фагимовна Сарвалиева, ординатор

450008; ул. Ленина, д. 3; Уфа

Alina F. Sarvalieva, MD, Clinical Resident

450008; 3 Lenin Str.; Ufa

https://orcid.org/0009-0006-1583-0447ХалитоваИ. В.KhalitovaI. V.

Ильнара Вильсоровна Халитова, ординатор

450008; ул. Ленина, д. 3; Уфа

Ilnara V. Khalitova, MD, Clinical Resident

450008; 3 Lenin Str.; Ufa

https://orcid.org/0009-0009-7015-3030ЖукТ. М.ZhukT. M.

Татьяна Максимовна Жук, ординатор

344022; Нахичеванский переулок, д. 29; Ростов-на-Дону

Tatyana M. Zhuk, MD, Clinical Resident

344022; 29 Nakhichevansky Lane; Rostov-on-Don

https://orcid.org/0009-0001-8551-374XЕвдокимоваЛ. В.EvdokimovaL. V.

Людмила Владимировна Евдокимова, ассистент

430005;  Большевистская ул., д. 68; Саранск

Lyudmila V. Evdokimova, MD, Assistant

430005; 68 Bolshevistskaya Str.; Saransk

https://orcid.org/0009-0006-2882-3246АкбулатоваМ. А.AkbulatovaM. A.

Макка Адамовна Акбулатова, студент

362019;  ул. Пушкинская, д. 40; Владикавказ

Makka A. Akbulatova, Student

362019; 40 Pushkinskaya Str.; Vladikavkaz

https://orcid.org/0009-0005-2514-278XЗолотареваЯ. Р.ZolotarevaYa. R.

Яна Романовна Золотарева, студент

117997; ул. Островитянова, д. 1; Москва

Yana R. Zolotareva, Student

117997; 1 Ostrovityanova Str.; Moscow

https://orcid.org/0009-0007-3300-6272ЗайнышеваЛ. М.ZainyshevaL. M.

Лиана Минияровна Зайнышева, cтудент

450008; ул. Ленина, д. 3; Уфа

Liana M. Zainysheva, Student

450008; 3 Lenin Str.; Ufa

https://orcid.org/0009-0002-4140-8320БалоянС.BaloyanS.

Сусанна Балоян, студент

450008; ул. Ленина, д. 3; Уфа

Susanna Baloyan, Student

450008; 3 Lenin Str.; Ufa

https://orcid.org/0009-0009-4659-053XДрагуноваЭ. М.DragunovaE. M.

Элеонора Максимовна Драгунова, студент

344022; Нахичеванский переулок, д. 29; Ростов-на-Дону

Eleonora M. Dragunova, Student

344022; 29 Nakhichevansky Lane; Rostov-on-Don

https://orcid.org/0009-0007-9845-2484КореньковаА. А.KorenkovaA. A.

Анастасия Андреевна Коренькова, студент

295051; бульвар Ленина, д. 5/7; Симферополь

Anastasia A. Korenkova, Student

295051; 5/7 Lenin Boulevard; Simferopol

https://orcid.org/0009-0009-2669-5772БилялН. А.BilyalN. A.

Нариман Аметович Билял, студент

295051; бульвар Ленина, д. 5/7; Симферополь

Nariman A. Bilyal, Student

295051; 5/7 Lenin Boulevard; Simferopol

https://orcid.org/0000-0003-1053-6813СергеевЮ. П.SergeevYu. P.

Юрий Павлович Сергеев, cтудент

450008; ул. Ленина, д. 3; Уфа

Yuri P. Sergeev, Student

450008; 3 Lenin Str.; Ufa

ФГБОУ ВО «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияBashkir State Medical University, Health Ministry of Russian FederationRussian FederationФГБОУ ВО «Ростовский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical University, Health Ministry of Russian FederationRussian FederationФГБОУ ВО «Национальный исследовательский Мордовский государственный университет имени Н.П. Огарёва»РоссияOgarev National Research Mordovian State UniversityRussian FederationФГБОУ ВО «Северо-Осетинская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияNorth Ossetian State Medical Academy, Health Ministry of Russian FederationRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University, Health Ministry of Russian FederationRussian FederationФГАОУ ВО «Крымский федеральный университет имени В.И. Вернадского»РоссияVernadsky Crimean Federal UniversityRussian Federation202411032024182254267Copyright © Chigisheva E.K., Batyrshin I.I., Sarvalieva A.F., Khalitova I.V., Zhuk T.M., Evdokimova L.V., Akbulatova M.A., Zolotareva Y.R., Zainysheva L.M., Baloyan S., Dragunova E.M., Korenkova A.A., Bilyal N.A., Sergeev Y.P., 20242024Чигишева Э.Х., Батыршин И.И., Сарвалиева А.Ф., Халитова И.В., Жук Т.М., Евдокимова Л.В., Акбулатова М.А., Золотарева Я.Р., Зайнышева Л.М., Балоян С., Драгунова Э.М., Коренькова А.А., Билял Н.А., Сергеев Ю.П.Chigisheva E.K., Batyrshin I.I., Sarvalieva A.F., Khalitova I.V., Zhuk T.M., Evdokimova L.V., Akbulatova M.A., Zolotareva Y.R., Zainysheva L.M., Baloyan S., Dragunova E.M., Korenkova A.A., Bilyal N.A., Sergeev Y.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1967   Introduction

   Introduction. Obesity is a worldwide problem at epidemic scale. Bariatric surgery (BS) is the most effective method to treat morbid obesity characterized by long-term and positive effects on concomitant diseases. However, the effect of BS on female reproductive health has not been sufficiently studied to date, which makes relevant to conduct further investigations in this field.

   Aim

   Aim: to summarize research data assessing BS effect on female reproductive health.

   Materials and Methods

   Materials and Methods. There was conducted a search for publications in the electronic databases PubMed, eLibrary and Google Scholar to identify the following keywords and their combinations in Russian and English: "bariatric surgery", "reproductive health", "sex hormones", "pregnancy", "menstrual cycle", "fetal", "neonatal". The evaluation of the articles was carried out in accordance with the PRISMA recommendations. Based on search data, 868 publications from PubMed, 83 publications from eLibrary and 74 publications from Google Scholar were retrieved. After the selection procedure, 79 articles were included in the review.

   Results

   Results. To date, the data regarding the long-term BS effects on improved obesity-related endocrine disorders remain insufficient. It is better to recommend long-acting reversible contraceptives such as intrauterine device, to post-BS patients. Women with BS history should have a continuous comprehensive nutritional assessment as well as blood macronutrients and trace elements monitoring before, during and after pregnancy. Recognizing potential complications associated with BS in the anamnesis and timely seeking specialized medical aid or timely transfer of a patient to a specialized medical facility may improve pregnancy outcomes for a mother and paired newborn.

   Conclusion

   Conclusion. While making decision to perform BS, it is necessary to fully understand its impact on female reproductive health, assess patients' reproductive intentions and fulfill health education obligations. All patients of childbearing age who are candidates for BS should participate in a joint decision-making dialogue on BS-related risks and benefits for reproductive health, which should be supported by extensive multidisciplinary work involving obstetricians, gynecologists, endocrinologists, psychologists and representatives of other medical specialties. To date, the data regarding the BS-related effects on pregnant women are heterogeneous, which requires additional investigations in this field.

   Введение

   Введение. Ожирение является глобальной проблемой и имеет масштабы эпидемии. Бариатрическая хирургия (БХ) является наиболее эффективным методом терапии морбидного ожирения, характеризующимся долгосрочностью и положительным влиянием в отношении сопутствующих заболеваний. Однако влияние БХ на репродуктивное здоровье женщин на сегодняшний день недостаточно изучено, что делает актуальным дальнейшие исследования в данной области.

   Цель

   Цель: обобщить научные данные по влиянию БХ на репродуктивное здоровье женщин.

   Материалы и методы

   Материалы и методы. Проведен поиск публикаций в электронных базах данных PubMed, eLibrary и Google Scholar. Стратегия поиска включала наличие следующих ключевых слов и их сочетаний на русском и английском языках: «бариатрическая хирургия», «репродуктивное здоровье», «половые гормоны», «беременность», «менструальный цикл», «фетальный», «неонатальный», «bariatric surgery»,«reproductive health», «sex hormones», «pregnancy», «menstrual cycle», «fetal», «neonatal». Оценка статей проводилась в соответствии с рекомендациями PRISMA. В результате поиска было извлечено 868 публикаций из PubMed, 83 публикации из eLibrary и 74 публикации из Google Scholar. После процедуры отбора в обзор было включено 79 статей.

   Результаты

   Результаты. На сегодняшний день недостаточно данных о долгосрочном влиянии БХ на улучшение связанных с ожирением эндокринных расстройств. Пациенткам, имеющим БХ в анамнезе, лучше рекомендовать обратимые контрацептивы длительного действия, например, внутриматочную спираль. У женщин с выполненным бариатрическим хирургическим вмешательством в анамнезе следует проводить непрерывную комплексную оценку питания и мониторинг содержания макронутриентов и микроэлементов в крови до, во время и после беременности. Распознавание возможных осложнений, связанных с бариатрической операцией в анамнезе, и своевременное обращение за специализированной помощью или своевременный перевод пациентки в специализированное медицинское учреждение могут улучшить исходы беременности для матери и новорожденного.

   Заключение

   Заключение. Принимая решение о проведении бариатрической операции, необходимо полностью осознавать ее влияние на репродуктивное здоровье женщин, оценивать репродуктивные намерения пациенток и выполнять обязательства по санитарному просвещению. Все пациентки детородного возраста, которые являются кандидатами на БХ, должны участвовать в совместном диалоге по принятию решений о рисках и преимуществах хирургического вмешательства для репродуктивного здоровья, для поддержания которого должна проводиться большая мультидисциплинарная работа, включая акушеров-гинекологов, эндокринологов, психологов и представителей других специальностей. На сегодняшний день данные, касающиеся последствий БХ для беременных, разнородны, что требует проведения дополнительных исследований в этой области.

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The authors declare that there are no conflicts of interest present.