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Young et al. Mini-invasive Surg 2018;2:16 I http://dx.doi.org/10.20517/2574-1225.2017.50 Page 7 of 12

Small for gestational age
Study name
Adams
Ducarme
Johannsson
Kjaer
Lapolla
Patel
Overall

0.5 0.75 1.5 2.5
Less likely for BS Pt More likely for BS Pt Graph generated by DistillerSR
1

Figure 6. Small for gestational age

Large for gestational age
Study name OR
Adams 0.51
Johannsson 0.33
Kjaer 0.31

Lapolla 0.61
Parker 0.6
Overall 0.49
0

0.5 0.75 1.5 2
Less likely for BS Pt More likely for BS Pt Graph generated by DistillerSR
1
Figure 7. Large for gestational age

DISCUSSION
Main findings
Our findings in this meta-analysis are that women affected by obesity who undergo bariatric surgery have
a decreased incidence of cesarean section, assisted delivery, LGA and macrosomic neonates as compared to
obese controls. In addition, there was an increased incidence of pregnancy-induced hypertension and SGA
and IUGR neonates in the post-surgical candidates. There was no difference in the incidence of gestational
diabetes or premature delivery in these two groups.

Cesarean section
Previous systematic reviews have shown inconsistent results in cesarean section rates after bariatric surgery [10-12] .
Vrebosch et al. found a lower incidence of C-sections while both Galazis et al. and Yi et al. found
[11]
[12]
[10]
no difference.
In the 10 studies used for this review, there was a large variation in their results [13,14,16-19,21-24] . One study found
surgery as an independent risk factor while two studies found a decreased rate of C-sections among the
[22]