BACKGROUND While obesity presents specific acute and long-term risks to the pregnant woman and her offspring, the effects of bariatric surgery on pregnancy outcomes are undetermined. OBJECTIVE A systematic review was performed according to the Academy of Nutrition and Dietetics Evidence Analysis Library process to determine the effects of bariatric surgery on both maternal and infant health outcomes of pregnancy. DESIGN A comprehensive literature search of PubMed was conducted to identify studies published from years 2000 to 2015 that examined the health effects of pregnancy after bariatric surgery. Experimental studies and observational studies with a control group were included. MAIN OUTCOME MEASURES Outcomes of interest were gestational weight gain, maternal complications (ie, gestational diabetes, pre-eclampsia, eclampsia, hypertension, and postpartum hemorrhage), miscarriage and/or stillbirth, cesarean section, birth weight in grams, birth weight in categories (ie, macrosomia, low birth weight, small for gestational age, and large for gestational age), gestational age and preterm birth, infant illness and complications (ie, perinatal death, admission to neonatal intensive care unit, neonatal illness, and congenital malformation rates), and Apgar scores. RESULTS Thirteen of 246 studies were included. Compared to body mass index-matched controls without surgery, bariatric surgery before pregnancy reduced infant birth weight in grams, with no effect on total maternal gestational weight gain or Apgar scores. Surgery did not increase risk of adverse outcomes, such as miscarriage and/or stillbirth, preterm birth, or infant complications. Effects of surgery on maternal complications, infant birth weight categories, and surgical delivery rates were inconsistent. CONCLUSIONS Bariatric surgery is a successful treatment of maternal obesity, but certain surgery-specific risks may exist. More data are needed to determine clinical guidelines. The long-term effects of surgery on pregnancy outcomes are unknown.

中文翻译：

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减肥手术对母婴妊娠结局的影响——证据分析中心系统评价

背景虽然肥胖会给孕妇及其后代带来特定的急性和长期风险，但减肥手术对妊娠结果的影响尚未确定。目的 根据营养与饮食学会证据分析图书馆流程进行系统评价，以确定减肥手术对孕产妇和婴儿健康结果的影响。设计 对 PubMed 进行了全面的文献检索，以确定 2000 年至 2015 年间发表的研究减肥手术后怀孕对健康影响的研究。包括对照组的实验研究和观察研究。主要结局指标 感兴趣的结局是妊娠期体重增加、母体并发症（即妊娠期糖尿病、先兆子痫、子痫、高血压、和/或产后出血）、流产和/或死产、剖宫产、出生体重（克）、出生体重类别（即巨大儿、低出生体重、小于胎龄和大于胎龄）、胎龄和早产，婴儿疾病和并发症（即围产期死亡、新生儿重症监护病房的入院、新生儿疾病和先天畸形率）和 Apgar 评分。结果 246 项研究中的 13 项被纳入。与未进行手术的体重指数匹配对照相比，怀孕前的减肥手术减少了婴儿出生体重（以克为单位），而对孕期总体重增加或 Apgar 评分没有影响。手术不会增加不良结局的风险，例如流产和/或死产、早产或婴儿并发症。手术对产妇并发症的影响，婴儿出生体重类别和手术分娩率不一致。结论 减肥手术是一种成功治疗孕产妇肥胖的方法，但可能存在某些特定于手术的风险。需要更多数据来确定临床指南。手术对妊娠结局的长期影响尚不清楚。