Abstract
Objectives
To investigate the association between pregnancy after bariatric surgery and adverse perinatal outcomes.
Design
Systematic review and meta‐analysis of current evidence base to collate findings and identify research gaps. PROSPERO registration: CRD42017051537.
Methods
Six electronic databases were searched from inception to June 2017 and supplemented by searches of reference lists, citations and relevant journals. The primary outcomes are congenital anomalies and perinatal mortality. Secondary outcomes include additional adverse perinatal outcomes such as preterm birth and small‐for‐gestational‐age (SGA) neonates. Observational studies published in English language that used obesity or BMI‐matched controls were included. Assessment for suitability of pooling data to Meta‐analyse is on‐going.
Results
Seventeen studies were included with 7742 women who had bariatric surgery prior to pregnancy and 205 796 controls. The studies seem to suggest a reduced risk of macrosomia, large‐for‐gestational‐age (LGA) neonates and post‐term birth but an increased risk of preterm birth and SGA neonates. An increased risk of NICU admission, miscarriage and perinatal mortality were observed in single studies. Only two studies investigated congenital anomalies but had conflicting results and associations were not significant.
Conclusions
Bariatric surgery prior to pregnancy appears to be associated with increased risk of SGA neonates and preterm birth. The use of small sample sizes in multiple studies may have resulted in non‐significance and large confidence intervals for rare outcomes. Meta‐analysis will address this limitation to some extent by increasing power. Larger scale studies of national and international data are required to overcome sample size limitations for rare outcomes.
To investigate the association between pregnancy after bariatric surgery and adverse perinatal outcomes.
Design
Systematic review and meta‐analysis of current evidence base to collate findings and identify research gaps. PROSPERO registration: CRD42017051537.
Methods
Six electronic databases were searched from inception to June 2017 and supplemented by searches of reference lists, citations and relevant journals. The primary outcomes are congenital anomalies and perinatal mortality. Secondary outcomes include additional adverse perinatal outcomes such as preterm birth and small‐for‐gestational‐age (SGA) neonates. Observational studies published in English language that used obesity or BMI‐matched controls were included. Assessment for suitability of pooling data to Meta‐analyse is on‐going.
Results
Seventeen studies were included with 7742 women who had bariatric surgery prior to pregnancy and 205 796 controls. The studies seem to suggest a reduced risk of macrosomia, large‐for‐gestational‐age (LGA) neonates and post‐term birth but an increased risk of preterm birth and SGA neonates. An increased risk of NICU admission, miscarriage and perinatal mortality were observed in single studies. Only two studies investigated congenital anomalies but had conflicting results and associations were not significant.
Conclusions
Bariatric surgery prior to pregnancy appears to be associated with increased risk of SGA neonates and preterm birth. The use of small sample sizes in multiple studies may have resulted in non‐significance and large confidence intervals for rare outcomes. Meta‐analysis will address this limitation to some extent by increasing power. Larger scale studies of national and international data are required to overcome sample size limitations for rare outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | PP.014 |
| Journal | BJOG-An International Journal of Obstetrics and Gynaecology |
| Volume | 125 |
| Issue number | S2 |
| DOIs | |
| Publication status | Published - Apr 2018 |
| Event | British Maternal & Fetal Medicine Society (BMFMS) 20th Annual Conference 2018 - Brighton, UK Duration: 19 Apr 2018 → 20 Apr 2018 |
