Use of bariatric surgery has increased dramatically during the past 10 years, particularly among women of reproductive age.
Dr Melinda Maggard and colleagues from California, USA estimated bariatric surgery rates among women aged 18 to 45 years, and assessed the published literature on pregnancy outcomes and fertility after surgery.
The team searched the multiple electronic databases including Medline, EMBASE, Controlled Clinical Trials Register Database, and the Cochrane Database of Reviews of Effectiveness.
Search terms included bariatric procedures, fertility, contraception, pregnancy, and nutritional deficiencies. Information was abstracted about study design, fertility, and nutritional, neonatal, and pregnancy outcomes after surgery.
|Neonatal outcomes were similar or better after surgery|
|Journal of the American Medical Association|
The research team screened 260 articles published between 1985 and 2008 on bariatric surgery among women of reproductive age, of which 75 were included.
Women aged 18 to 45 years accounted for 49% of all patients undergoing bariatric surgery.
Three matched cohort studies showed lower maternal complication rates after bariatric surgery than in obese women without bariatric surgery, or rates approaching those of nonobese controls.
In 1 matched cohort study that compared maternal complication rates in women after laparoscopic adjustable gastric band surgery with obese women without surgery, rates of gestational diabetes and preeclampsia were lower in the bariatric surgery group.
Findings were supported by 13 other bariatric cohort studies.
The team found that neonatal outcomes were similar or better after surgery compared with obese women without laparoscopic adjustable gastric band surgery.
The research team noted no differences in neonatal outcomes were found after gastric bypass compared with nonobese controls
Findings were supported by 10 other studies.
Studies regarding nutrition, fertility, cesarean delivery, and contraception were limited.
Dr Maggard’s team concluded, “Rates of many adverse maternal and neonatal outcomes may be lower in women who become pregnant after having had bariatric surgery compared with rates in pregnant women who are obese.”
“However, further data are needed from rigorously designed studies.”