A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery.

BACKGROUND

The effects of bariatric surgery (BS) on outcomes in subsequent pregnancies are unclear.

OBJECTIVES

To compare maternal and fetal outcomes among women who become pregnant after BS and obese women who have not undergone BS before pregnancy.

SEARCH STRATEGY

PubMed and Embase were searched for relevant reports, and the reference lists of identified articles were hand-searched.

SELECTION CRITERIA

Cohort studies that compared outcomes among women who had undergone any type of BS and obese women who had not undergone surgery were included when results were reported as risk ratios or odds ratios (ORs).

DATA COLLECTION AND ANALYSIS

Summary ORs were estimated using a random effects model.

MAIN RESULTS

Eleven studies were included. Compared with obese women who had not undergone BS, women who had undergone BS had significantly lower odds of gestational diabetes (OR 0.31; 95% CI 0.15-0.65), hypertensive disorders (OR 0.42; 95% CI 0.23-0.78), and macrosomia (OR 0.40; 95% CI 0.24-0.67). However, their odds of small-for-gestational-age newborns were increased (OR 2.16; 95% CI 1.28-3.66). No significant differences were recorded for cesarean, postpartum hemorrhage, and preterm delivery.

CONCLUSIONS

BS reduces the odds of some adverse maternal and fetal outcomes among obese women.