Maternal and neonatal outcomes after bariatric surgery; a systematic review and meta-analysis: do the benefits outweigh the risks?

摘要: Objective Data Obesity during pregnancy is associated with a number of adverse obstetric outcomes that include gestational diabetes mellitus, macrosomia, and preeclampsia. Increasing evidence shows bariatric surgery may decrease the risk these outcomes. Our aim was to evaluate benefits risks in obese women according Study We performed systematic literature search using MEDLINE, Embase, Cochrane, Web Science, PubMed from inception up December 12, 2016. Studies were included if they evaluated patients who underwent surgery, reported subsequent outcomes, compared control group. Appraisal Synthesis Methods Two reviewers extracted study independently, bias assessed use Newcastle-Ottawa Quality Assessment Scale. Pooled odds ratios for each outcome estimated Dersimonian Laird random effects model. Results After review 2616 abstracts, 20 cohort studies approximately 2.8 million subjects (8364 whom had surgery) metaanalysis. In our primary analysis, showed reduced rates mellitus (odds ratio, 0.20; 95% confidence interval, 0.11–0.37, needed benefit, 5), large-for-gestational-age infants 0.31; 0.17–0.59; 6), hypertension 0.38; 0.19–0.76; 11), all hypertensive disorders 0.27–0.53; 8), postpartum hemorrhage 0.32; 0.08–1.37; 21), caesarean delivery 0.50; 0.38–0.67; 9); however, group an increase small-for-gestational-age 2.16; 1.34–3.48; harm, intrauterine growth restriction 66), preterm deliveries 1.35; 1.02–1.79; 35) when matched presurgery body mass index. There no differences preeclampsia, neonatal intensive care unit admissions, stillbirths, malformations, death. Malabsorptive surgeries resulted greater ( P =.0466) = Conclusion Although reduction several there potential increased other important should be considered discussed reproductive-age women.