Results
From a total of 3,276,776 of women who gave birth during 2007-2015,
8,167 (0.25%) underwent non-obstetric abdominal surgery, including
5,109 laparotomy patients and 3,108 laparoscopy patients. Table 1 shows
the pregnancy characteristics of patients with or without surgery during
pregnancy.
Table 1 shows the general and pregnancy characteristics of patients
between pregnancies with and without surgery. For pregnancies in the
surgery group, maternal age < 35 years, nulliparity, preterm
birth, LBW, gestational hypertension, GDM, C/S, placenta previa, and
placenta abruption were more common than in pregnancies in the group
that did not undergo surgery. Table 2 shows the general and pregnancy
characteristics of the laparoscopy and laparotomy groups. When comparing
laparoscopy and laparotomy, in the laparoscopy group, maternal age
< 35 years, nulliparity, C/S, gestational hypertension, GDM,
and placenta previa were more common than in the laparotomy group.
Preterm delivery, low birth weight, and placenta abruption were less
common in the laparoscopic group compared with the laparotomy group.
Figure 2 shows the results of Cox proportional hazards regression
analyses with fetal and obstetric complications after controlling for
age and parity. There was a statistically significant increase in risk
of preterm birth (HR 2.06, 95% CI 1.86-2.29), LBW (HR 1.65, 95% CI
1.49-1.82), C/S (HR 1.14, 95% CI 1.09-1.19), gestational hypertension
(HR 1.36, 95% CI 1.19-1.56), and placenta previa (HR 1.57, 95% CI
1.33-1.87) in both the laparotomy and laparoscopy groups. The risk of
placental abruption was significantly increased only in the laparotomy
group (HR 1.59, 95% CI 1.12-2.27).
When comparing the laparoscopic and laparotomy groups for risk of fetal
outcomes, the risk of LBW was significantly decreased in laparoscopic
adnexal resection during pregnancy compared to laparotomy (HR 0.62, 95%
CI 0.40-0.95) (Table 3). Otherwise, there were no statistically
significant differences between the two groups. In addition, in the
laparoscopic group, the hospital stay was statistically significantly
shorter than for the laparotomy group (6.13±2.76 vs. 5.62±2.75 days,
P<0.001).