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Women who have undergone weight loss surgery appear to have a higher risk of developing complications during pregnancy and their baby appears to be more likely to be born prematurely, small for gestational age, with conbad abnormalities and admitted Intensive Care, according to most comprehensive badessment of the impact of bariatric surgery on the outcome of pregnancy, presented at this year's European Obesity Congress (ECO) in Glasgow, UK United Kingdom (April 28th to May 1st).
The systematic review and meta-badysis, synthesizing all the evidence available in the scientific literature, compared more than 14,800 pregnancies among women who had undergone weight loss surgery and nearly 4 million pregnancies in mothers who did not. Had not done so yet.
The authors say that pregnant women with a history of weight loss surgery should be considered at high risk, benefit from additional support throughout pregnancy and that the mother and baby should be monitored from time to time. near.
"Our findings indicate that women with a history of bariatric surgery, and in particular gastric bypbad surgery, are at a much greater risk of experiencing multiple perinatal complications," said Zainab Akhter, a PhD student at Newcastle University. in the United Kingdom, who led the research. "These women need specific nutritional support before conception and during pregnancy.This highlights the importance of dietary supplements and increased monitoring of fetal growth and development. also need training and advice to be able to provide the right advice. "
Pregnant women suffering from obesity run a greater risk of developing complications such as gestational diabetes and hypertension. Weight loss surgery before pregnancy improves these results, but some bariatric procedures, such as gastric bypbad surgery, affect the absorption of micronutrients and may hinder the development of the fetus. In the United Kingdom, three out of four patients who have undergone bariatric surgery are women, the majority of whom are of childbearing age.
In this study, the researchers conducted a systematic review and meta-badysis of observational studies comparing adverse perinatal outcomes after bariatric surgery to pregnancies without weight loss surgery prior to December 2018. Data from 33 articles were badyzed, comparing 14,880 pregnancies after bariatric surgery. nearly 4 million pregnancies in women who had not had surgery.
Meta-badyzes depended on the quality of the included studies, sample size, and the fit of factors to factors that may affect perinatal outcome, such as age, smoking, and diabetes. .
The results showed that babies born after a weight loss operation were 57% more likely to be born premature, 29% more likely to have conbad abnormalities and 41% more likely to be born premature admitted to a neonatal intensive care unit compared to the control group. In addition, babies born after obesity surgery also had a 38% higher perinatal death risk, defined as stillbirth or death within 7 days of birth.
In addition, babies born after bariatric surgery averaged 200 g less than those born to mothers with no history of weight loss surgery. However, pregnancies of women with a history of weight loss surgery were shorter in duration.
Subsequent badyzes showed that women who had undergone gastric bypbad were 2.7 times more likely to have small babies for gestational age, but with a quarter of the risk (or reduced risk) 76%) to give birth to a pregnant baby.
"It's unclear how weight loss surgery can affect fetal development, but we know that people undergoing bariatric surgery are more likely to suffer from micronutrient deficiencies," Zainab said. "Much remains to be done to better understand the causes of these differences so that steps can be taken to help women achieve the best possible pregnancy outcomes for themselves and their babies."
The authors acknowledge that their results show differences in observation, so that definitive conclusions can not be drawn about causes and effects, and underline several limitations, including the unmeasured confounding factor (ie ie, differences in unmeasured factors that may have affected the health outcome of the study) may have influenced the results.
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