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Maternal and neonatal outcomes in women undergoing Roux-en-Y gastric bypass: A systematic review and meta-analysis.

BACKGROUND: To summarize evidence of benefits and risks of maternal and neonatal outcomes among pregnant women after Roux-en-Y gastric bypass surgery. METHODS: A systematic search was conducted in MEDLINE, EMBASE, Web of Science, Ovid and Cochrane Library until 24th May 2021. Inclusion criteria were randomized trails or observational studies including at least one of maternal or neonatal outcomes from pregnant women who had a history of Roux-en-Y gastric bypass surgery with a control group of pregnant women with no history of bariatric surgery. Non-English studies were excluded. Both fixed-effect and random-effect models were used in the meta-analyses. Newcastle-Ottawa Scale was used to assess quality of studies. RESULTS: Twelve retrospective articles were eligible including 13 848 pregnant women with a history of Roux-en-Y gastric bypass surgery and 255 008 pregnant women without a history of bariatric surgery. The results of meta-analysis showed a lower incidence of preterm premature rupture of membranes (OR 0.53, 95% CI [0.47, 0.60], p < 0.00001), large gestational age infants (OR 0.28, 95%CI [0.22, 0.37], p < 0.00001) or macrosomia (OR 0.26, 95%CI [0.23, 0.30], p < 0.00001) in women after Roux-en-Y gastric bypass surgery. On the other hand, infants born to mothers with a history of Roux-en-Y gastric bypass surgery had an increased risk of small gestational age (OR 2.24, 95% CI [1.55, 3.24], p < 0.00001). CONCLUSION: Roux-en-Y gastric bypass surgery reduces significantly of risks of preterm premature rupture of membranes and large for gestational age/ macrosomia, but increase the risk of small for gestational age.

Authors

  • Yang, Siyu, Yang S, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Nursing Department, PR China.

  • Zhou, Leshan, Zhou L, Nursing School of Central South University, Changsha, Hunan, PR China.

  • Chen, Yijing, Chen Y, Wuhan Mental Health Center affiliated Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

  • Krewski, Daniel, Krewski D, McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; Risk Sciences International. Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Canada; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada; Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada.

  • Wu Wen, Shi, Wu Wen S, McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; Risk Sciences International. Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Canada; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada; Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada.

  • Xie, Ri-Hua, Xie RH, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada; Department of Nursing, General Practice Center Nanhai Hospital, Southern Medical University, Guangzhou, PR China. Electronic address: xierihua928@hotmail.com.

YEAR OF PUBLICATION: 2021
SOURCE: Eur J Obstet Gynecol Reprod Biol. 2021 Sep;264:117-127. doi: 10.1016/j.ejogrb.2021.07.006. Epub 2021 Jul 7.
JOURNAL TITLE ABBREVIATION: Eur J Obstet Gynecol Reprod Biol
JOURNAL TITLE: European journal of obstetrics, gynecology, and reproductive biology
ISSN: 1872-7654 (Electronic) 0301-2115 (Linking)
VOLUME: 264
PAGES: 117-127
PLACE OF PUBLICATION: Ireland
ABSTRACT:
BACKGROUND: To summarize evidence of benefits and risks of maternal and neonatal outcomes among pregnant women after Roux-en-Y gastric bypass surgery. METHODS: A systematic search was conducted in MEDLINE, EMBASE, Web of Science, Ovid and Cochrane Library until 24th May 2021. Inclusion criteria were randomized trails or observational studies including at least one of maternal or neonatal outcomes from pregnant women who had a history of Roux-en-Y gastric bypass surgery with a control group of pregnant women with no history of bariatric surgery. Non-English studies were excluded. Both fixed-effect and random-effect models were used in the meta-analyses. Newcastle-Ottawa Scale was used to assess quality of studies. RESULTS: Twelve retrospective articles were eligible including 13 848 pregnant women with a history of Roux-en-Y gastric bypass surgery and 255 008 pregnant women without a history of bariatric surgery. The results of meta-analysis showed a lower incidence of preterm premature rupture of membranes (OR 0.53, 95% CI [0.47, 0.60], p < 0.00001), large gestational age infants (OR 0.28, 95%CI [0.22, 0.37], p < 0.00001) or macrosomia (OR 0.26, 95%CI [0.23, 0.30], p < 0.00001) in women after Roux-en-Y gastric bypass surgery. On the other hand, infants born to mothers with a history of Roux-en-Y gastric bypass surgery had an increased risk of small gestational age (OR 2.24, 95% CI [1.55, 3.24], p < 0.00001). CONCLUSION: Roux-en-Y gastric bypass surgery reduces significantly of risks of preterm premature rupture of membranes and large for gestational age/ macrosomia, but increase the risk of small for gestational age.
COPYRIGHT INFORMATION: Copyright (c) 2021 Elsevier B.V. All rights reserved.
LANGUAGE: eng
DATE OF PUBLICATION: 2021 Sep
DATE OF ELECTRONIC PUBLICATION: 20210707
DATE COMPLETED: 20210921
DATE REVISED: 20250623
MESH DATE: 2021/09/22 06:00
EDAT: 2021/07/24 06:00
STATUS: MEDLINE
PUBLICATION STATUS: ppublish
LOCATION IDENTIFIER: S0301-2115(21)00341-9 [pii] 10.1016/j.ejogrb.2021.07.006 [doi]
OWNER: NLM

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Daniel Krewski

Chief Risk Scientist

Dr. Daniel Krewski is Chief Risk Scientist and co-founder of Risk Sciences International (RSI), a firm established in 2006 to bring evidence-based, multidisciplinary expertise to the challenge of understanding, managing, and communicating risk. As RSI’s inaugural CEO and long-time scientific...
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