Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women

Abenhaim, Haim A.; Alrowaily, Nouf; Czuzoj‐Shulman, Nicholas; Spence, Andrea R.; Klam, Stephanie

doi:10.3109/14767058.2016.1143927

Cited by 32 publications

(38 citation statements)

References 42 publications

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“…There was considerable variability across studies in the reported frequency of birth defects, likely due to differences in ascertainment and inclusion criteria. For example, Abenhaim et al used hospital discharge data, did not describe birth defect inclusion criteria, and reported less than one per cent of exposed and unexposed infants as having a birth defect . In contrast, Parent et al defined birth defects as any malformation diagnosis on the birth certificate or delivery discharge diagnoses (International Classification of Diseases codes 740‐756, excluding chromosomal abnormalities) and reported 22% and 16% of infants were affected in the exposed and unexposed groups, respectively .…”

Section: Resultsmentioning

confidence: 99%

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Bariatric surgery and birth defects: A systematic literature review

Benjamin

Littlejohn

Mitchell

2018

Paediatric Perinatal Epid

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Background: Bariatric procedures are on the rise. The risk of birth defects in pregnancies following such procedures may be increased (e.g. due to nutrient deficiencies) or decreased (e.g. due to decreased maternal body mass index, BMI). Methods: We conducted a systematic literature review of the association between bariatric surgery and birth defects using Ovid MEDLINE and PubMed (1946-2017). Information was abstracted on study design, exposures, outcomes, covariates, and estimates of association. Results: Fifteen studies met our inclusion criteria; 14 evaluated the outcome of any birth defect and one evaluated neural tube defects. Estimates of association between bariatric surgery and birth defects were available for nine studies and ranged from 0.6-1.9 (all 95% confidence intervals included 1.0). When studies were stratified by surgery type, there was no obvious pattern of association. When stratified by the approach used to account for BMI, positive associations were observed in studies that did not account for maternal prepregnancy BMI or used women with normal BMI as the reference group (range: 1.3-1.9). Estimates from studies that either matched or adjusted for prepregnancy BMI were closer to the null (range: 1.1-1.2) and studies that compared to morbidly obese women reported protective associations (range: 0.6-0.7). Conclusions: Studies of the association between bariatric surgery and birth defects vary with respect to the surgical procedures included, birth defects ascertainment methods, and approaches used to account for maternal BMI. Consequently, it is not possible to draw a conclusion regarding the association between bariatric surgery and birth defects. Additional studies are warranted.

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Section: Resultsmentioning

confidence: 99%

“…Five studies evaluated the association between any bariatric surgery procedure and any birth defect . In these five studies, estimates of association ranged from 0.7 to 1.9, with four of the five studies reporting estimates greater than 1.0 (range: 1.1‐1.9) (Table ).…”

Section: Resultsmentioning

confidence: 99%

Bariatric surgery and birth defects: A systematic literature review

Benjamin

Littlejohn

Mitchell

2018

Paediatric Perinatal Epid

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“…En fant også hyppigere forekomst av blodtransfusjon etter fødsel og venøse tromboembolismer hos denne gruppen kvinner (9). Kjaer og medarbeidere finner imidlertid ikke belegg i sin studie for å si at risikoen for indusert fødsel er økt hos denne gruppen kvinner, sammenliknet med en kontrollgruppe (10).…”

Section: • • •unclassified

“…Enkelte studier har avdekket en høyere risiko for å få barn som er små for alderen (13), og også en høyere forekomst av intrauterin veksthemning (14). Abenhaim og medarbeidere viser i sin ferske studie til funn som peker i retning av at intrauterin veksthemning faktisk forekommer hyppigere hos kvinner som har gjennomgått fedmekirurgi, sammenliknet med sykelig overvektige kvinner (9). «Enkelte studier har avdekket en høyere risiko for å få barn som er små for alderen.» Den registerbaserte kohortstudien til Kjaer og medarbeidere konkluderer med at nyfødte av mødre som har gjennomgått fedmekirurgi, har lavere fødselsvekt, lavere gestasjonsalder og 2,3 ganger høyere risiko for å vaere SGA-barn sammenliknet med en matchende gruppe kvinner som ikke har gjennomgått fedmekirurgi.…”

Section: Lavere Fødselsvekt Preterm Fødselunclassified

Svangerskap og fødsel etter fedmeoperasjon: Hva bør jordmødre vite?

Søpstad¹

2018

Sykepleien

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“…Five studies were included in our review of IUGR rates in respect to bariatric surgery [14,16,[22][23][24] . Individually, they found either no difference or an increased rate of IUGR among the bariatric surgical patient as compared to their control.…”

Section: Iugrmentioning

confidence: 99%

Maternal and fetal delivery outcomes in pregnancies following bariatric surgery: a meta-analysis of the literature

Young¹,

Drew²,

Ibikunle³

et al. 2018

MIS

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Aim: The objective of this study is to evaluate maternal and fetal outcomes following pregnancies after bariatric surgery as compared to the general population affected by obesity. Methods:A systematic review was conducted through MEDLINE, Cochrane, and EMBASE to identify relevant studies from 2007 to 2016 with comparative data on the maternal and fetal delivery outcomes following bariatric surgery as compared to the population affected by obesity. The primary outcome analyzed was the rate of cesarean deliveries.Other outcomes included intrauterine growth restriction, small for gestational age, large for gestational age, macrosomia pregnancy-induced hypertension, gestational diabetes, assisted vaginal delivery, and preterm delivery. Statistical analysis was done using fixed-effects meta-analysis to compare the mean value of the two groups (Comprehensive Meta-Analysis Version 3.3.070 software; Biostat Inc., Englewood, NJ). Results:Out of 549 studies, 13 were quantitatively assessed and included for meta-analysis. The need for caesarean sections in post-bariatric women was found to be significantly lower when compared to women affected by obesity [odds ratio (OR) 0.623, P < 0.001). There were also significant reduction in the incidence of LGA (OR 0.491, P < 0.001), macrosomia (OR 0.251, P < 0.001), and assisted vaginal delivery (OR 0.807, P < 0.001) in the post bariatric group of women. There was an increase in the incidence of PIH (OR 1.113, P < 0.001), SGA (OR 2.305, P < 0.001) and IUGR (OR 2.099, P < 0.001). The incidence of preterm delivery (OR 0.982, P > 0.05) and gestational diabetes (OR 1.046, P > 0.05) were similar in both groups. Conclusion:Patients affected by obesity considering conceiving in the near future should consider bariatric surgery prior to conception to lower their risk of potentially adverse delivery outcomes.

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Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women

Cited by 32 publications

References 42 publications

Bariatric surgery and birth defects: A systematic literature review

Bariatric surgery and birth defects: A systematic literature review

Svangerskap og fødsel etter fedmeoperasjon: Hva bør jordmødre vite?

Maternal and fetal delivery outcomes in pregnancies following bariatric surgery: a meta-analysis of the literature

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