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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 9 of 12

Prematurity
Study name
Abenhaim
Amsalem
Ducarme
Johannsson
Kjaer
Lapolla
Patel

Santulli
Stephanson
Overall

0.5 0.75 1.5 2
Less likely for BS Pt More likely for BS Pt Graph generated by DistillerSR
1

Figure 10. Premature delivery

PIH
There was variation among the 8 studies used in this analysis [13,14,16,18,19,22-24] . While the majority of the studies
showed no difference in the two groups, Parker et al. showed an increase in PIH. Parker et al. theorized
[22]
[22]
this is likely due to the fact that the average bariatric candidate is white and older which pre-disposes them
to hypertension.

GD
Prior systematic reviews have shown either a decrease or no change in the rates of GD among the bariatric
surgery patient [10-12] . The 9 studies used in this review are no exception [13,14,16,18-23] . While there were 4 papers
showing a decrease in the rates of GD [13,16,20,22] , the majority did not show a difference. It has been theorized
that there is a reduction in the rates of GD after bariatric surgery due to absorption or metabolic changes .
[24]
However, our data did not show a difference in the rates of GD between the two groups. This is likely due to
the metabolic changes associated with prolonged obesity and is not related to surgery.

IUGR
Five studies were included in our review of IUGR rates in respect to bariatric surgery [14,16,22-24] . Individually,
they found either no difference or an increased rate of IUGR among the bariatric surgical patient as compared
to their control. In analyzing the five studies together, we concluded there was an increased rate of IUGR in
association with bariatric surgery.

The explanation for this finding remains unknown. It has been theorized that malabsorption and nutritional
deficiencies during the pregnancy may lead to the growth restriction; however fetal growth restriction has
many etiologies including aneuploidy, infection, and congenital malformations . Both malabsorption and
[23]
nutritional deficiencies are more often associated with gastric bypass procedures rather than the banding
procedure. A sub analysis to compare the two procedures was not able to be performed as two of the
studies only included the Roux-en-Y bypass [23,24] while the other three did not specify the surgical procedure
performed. Further studies would need to be performed to determine the IUGR rates in bypass versus
banding patients.