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Young et al. Mini-invasive Surg 2018;2:16 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.50

Meta-Analysis Open Access

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

literature

Brittanie Young , Samantha Drew , Christopher Ibikunle , Aliu Sanni 3
2
1
1
1 Family Medicine Residency, SRHS, Spartanburg, SC 29303, USA.
2 General Surgery, Georgia SurgiCare, Loganville, GA 30052, USA.
3 Bariatric and General Surgery, Eastside Bariatric and General Surgery LLC, Snellville, GA 30078, USA.
Correspondence to: Dr. Aliu Sanni, Bariatric and General Surgery, Eastside Bariatric and General Surgery LLC, 1800 Tree Lane,
Suite 350, Snellville, GA 30078, USA. E-mail: aliu.sanni@esbariatricandgeneralsurgery.com

How to cite this article: Young B, Drew S, Ibikunle C, Sanni A. Maternal and fetal delivery outcomes in pregnancies following
bariatric surgery: a meta-analysis of the literature. Mini-invasive Surg 2018;2:16. http://dx.doi.org/10.20517/2574-1225.2017.50

Received: 15 Dec 2017 First Decision: 3 Apr 2018 Revised: 9 Apr 2018 Accepted: 24 Apr 2018 Published: 28 Jun 2018

Science Editor: Niccolò Petrucciani Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
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.
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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