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 023-0.78), and macrosomia (OR 0.40; 95% CI 024-0.67). 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. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.