TUESDAY, Nov. 18 (HealthDay News) -- Among women who become pregnant after bariatric surgery, both maternal and neonatal outcomes may be improved, but definitive evidence is still lacking, according to a report published in the Nov. 19 issue of the Journal of the American Medical Association.

Melinda A. Maggard, M.D., of the University of California Los Angeles, and colleagues performed a systematic review of the literature in order to estimate bariatric surgery rates for women aged 18 to 45 years and assess pregnancy outcomes and fertility following bariatric surgery.

Of the 260 articles identified, only 75 met criteria for inclusion. The investigators found that, of the more than 50,000 bariatric surgeries performed annually, women aged 18 to 45 account for 49 percent of all cases. In three matched cohort studies, maternal complication rates were lower or approached the rates of non-obese controls when compared to obese women not undergoing bariatric surgery. In one matched cohort study, rates of gestational diabetes and preeclampsia were significantly lower among obese patients undergoing laparoscopic adjustable gastric band surgery compared to obese patients not undergoing the surgery. Neonatal outcomes related to premature delivery, low birth weight and macrosomia were also significantly improved among obese women undergoing laparoscopic adjustable gastric band surgery compared to those who did not, the report indicates.

"The available evidence suggests that risks for maternal complications, such as gestational diabetes and preeclampsia, may be lower following surgically induced weight loss than the risks in obese women and may approach community rates," the authors conclude. However, "optimizing success for contraception and producing healthy neonates following surgery will require a multidisciplinary effort by surgeons, primary care physicians, reproductive fertility specialists, obstetricians and patients."

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