Drever, Natalie, Moreno, Maria Castrejon, Mohammadpour, Zinat, O'Brien, Cecelia, Melville, Catriona, Black, Kirsten, and de Costa, Caroline (2026) The Effect of Weight Status on Risk of Perioperative Complications Associated With Surgical Abortion: A Meta-Analysis of Observational Studies. Australian and New Zealand Journal of Obstetrics and Gynaecology, 66 (2). e70092.

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Abstract

Background: There is a lack of evidence regarding the impact of body weight on the safety of surgical abortion.

Study Design: We performed a systematic review and meta-analysis of observational studies reporting the effects of obesity on perioperative anaesthetic and surgical outcomes during surgical abortion. Analytical observational studies examining individuals undergoing surgical abortion up to 28 weeks gestation were eligible for inclusion if they reported perioperative anaesthetic or surgical outcomes in participants with body mass index (BMI) in two groups: BMI < 30 kg/m2 and BMI ≥ 30 kg/m2. Sub-analyses were performed comparing outcomes in those with BMI < 30 kg/m2 and ≥ 40 kg/m2.

Results: Eight retrospective cohort studies were included, comprising 9912 obese and 31 672 non-obese participants. 1770 participants had BMI ≥ 40 kg/m2 and only 71 had BMI ≥ 50 kg/m2. BMI ≥ 30 kg/m2 was not associated with an increase in major surgical adverse outcomes (RR [95% CIs] 1.16 [0.83–1.62]) compared to BMI < 30 kg/m2. BMI ≥ 40 kg/m2 was associated with increased risk of major complications (RR [95% CIs] 2.60 [1.28–5.28]) based on low-quality evidence from two studies on second-trimester surgical abortion. Anaesthetic adverse outcomes were rare and not increased by BMI ≥ 30 kg/m2 (RR [95% CIs] 1.02 [0.50–2.06]) or BMI ≥ 40 kg/m2 (RR [95% CIs] 2.0 [0.55–7.24]).

Conclusions: Anaesthetic and surgical risks are not increased by BMI ≥ 30 kg/m2. Individuals with BMI ≥ 40 kg/m2 may have increased risk of major surgical complications. The lack of sufficient data on those in the BMI ≥ 40 kg/m2 and BMI ≥ 50 kg/m2 categories underscores the need for further research to ensure high-quality abortion care for this population.

Item ID:	93816
Item Type:	Article (Refereed Research - C1)
ISSN:	1479-828X
Keywords:	meta-analysis, obesity, surgical abortion, systematic review, weight
Copyright Information:	© 2026 Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Date Deposited:	27 Aug 2026 01:53
FoR Codes:	42 HEALTH SCIENCES > 4299 Other health sciences > 429999 Other health sciences not elsewhere classified @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200199 Clinical health not elsewhere classified @ 100%
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