Name: Monique Anne M.

Merin Date: September 29, 2022

Group: 3A-C Name of CI: Rambo Ebbes

I. TITLE: Pregnancy after bariatric surgery and adverse perinatal outcome: A systematic
review and meta-analysis
AUTHOR:
SOURCE: PLOS MEDICINE
YEAR OF PUBLICATION: 2019, August

II. SUMMARY
Reduced risks of preeclampsia and gestational diabetes, two serious complications that can have a negative impact on
both the mother and the fetus, are among the benefits of bariatric surgery performed prior to conception. This
systematic review and meta-goal analysis's is to discover whether pregnancies following bariatric surgery are
associated with poor perinatal outcomes. Our meta-analysis has demonstrated that after bariatric surgery, the risks of
post term birth and LGA babies are decreased; however, we have also identified adverse outcomes for the baby, and
attention must now be paid to how to reduce these. For a number of high-risk pregnancy groups, including those with
diabetes, hypertension, and obesity, there are international recommendations. This study demonstrates that women
who undergo bariatric surgery and conceive are also at high risk, and it highlights the need for guidelines for medical
professionals as the prevalence of obesity and bariatric surgery rises.
.

III. NURSING IMPLICATIONS

A. To Nursing Practice
The current evidence base could be used to direct risk communication with women of reproductive age prior to
surgery regarding potential future pregnancies. Preconception nutritional support and increased fetal, nutritional,
and glucose monitoring are necessary for women who have had bariatric surgery in the past. In addition to
improving pregnancy outcomes, interventions to reduce maternal obesity are crucial to lowering the long-term
health costs for both the mother and her offspring, such as cardiovascular disease and insulin resistance.

B. To Nursing Education
After bariatric surgery, meta-analysis has demonstrated a reduction in the risks of post-term birth and LGA
babies; however, we have also identified adverse outcomes for the baby, and our efforts now need to be
concentrated on how to reduce these. For a number of high-risk pregnancy groups, including those with
diabetes, hypertension, and obesity, there are international recommendations. This study demonstrates that
women who undergo bariatric surgery and conceive are also at high risk, and it highlights the need for
guidelines for medical professionals as the prevalence of obesity and bariatric surgery rises.

C. To Nursing Research
If restrictive surgery improves perinatal outcomes without negatively affecting maternal outcomes, it may be the
preferred procedure for women of reproductive age. However, more research is needed to make this
determination. Future research should examine how long it takes to conceive following various types of
bariatric surgery, especially with regard to gestational weight loss and older mothers. After bariatric surgery,
many women who were previously thought to be infertile experience increased fertility, which may cause
unexpected pregnancies right away after surgery in the rapid weight loss phase. The evidence for this
recommendation is weak, but many clinics advise waiting 12 to 18 months after surgery before trying to get
pregnant.

IV. PERSONAL INSIGHTS

I completely agree with the study that women who have had bariatric surgery prior to becoming pregnant have
higher odds of experiencing perinatal mortality, congenital anomalies, preterm birth, SGA, and NICU admission
than women who have not. However, post term birth and LGA are linked to lower odds after bariatric surgery.
Contrary to restrictive procedures, malabsorptive procedures were linked to a significant rise in SGA and a fall
in LGA. For the outcomes with a high value, subgrouping by type of surgery significantly reduced
heterogeneity, whereas subgrouping by control group did not.

Checked and Received: (Signature of CI/Date)