Malnutrition in Pregnancy

MIP: Weight Loss Surgery (2018)

Intervention
What are the health effects of pregnancy after weight loss surgery on gestational weight gain?
- Conclusion
  The evidence reviewed found no significant differences in gestational weight gain between women who had pregnancy after weight loss surgeries and those who had not (four out of five studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on gestational weight gain?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on maternal complications (from conception to six weeks postpartum), such as gestational diabetes, hypertensive disorders of pregnancy (pre-eclampsia or eclampsia, hypertension) and postpartum hemorrhage?
- Conclusion
  The evidence reviewed for the effects of pregnancy after weight loss surgery was inconsistent for most maternal complications (12 studies). Seven studies observed lower rates of gestational diabetes among women who had pregnancy after weight loss surgeries, while five studies reported similar findings in both groups. Five studies reported no effects on postpartum hemorrhage, while one study noted lower risk of postpartum hemorrhage in the weight loss surgery group. Four studies observed a lower rate of pre-eclampsia or eclampsia in the weight loss surgery group, while four studies reported similar findings in both groups. Two studies reported lower rate of hypertension in the weight loss surgery groups, while four studies reported similar findings in both groups. One study that combined both pre-eclampsia and hypertension reported no difference.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on maternal complications (from conception to six weeks postpartum), such as gestational diabetes, hypertensive disorders of pregnancy (pre-eclampsia/eclampsia, hypertension) and postpartum hemorrhage?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on miscarriages or stillbirths?
- Conclusion
  The evidence reviewed did not observe any significant differences in miscarriage or stillbirth between women who had pregnancy after weight loss surgeries and those who had not (four out of four studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on miscarriages or stillbirths?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on Caesarean section?
- Conclusion
  The evidence reviewed for the effects of pregnancy after weight loss surgery on Caesarean section was inconsistent (10 studies). Four studies reported lower rates of Caesarean section in the weight loss surgery group (vs. the comparison group), while one study observed opposite results. Four studies observed similar findings in both groups. One study noted lower rates of emergency Caesarean section in the weight loss surgery groups but no significant difference in planned Caesarean section.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on Caesarean section?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on birth weight (in grams)?
- Conclusion
  The evidence reviewed observed lower birth weight among infants born to women who had pregnancy after weight loss surgeries (nine out of 10 studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on birth weight (in grams)?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on birth weight (in categories)?
- Conclusion
  The effects of pregnancy after weight loss surgeries on macrosomia, low birth weight, small for gestational age and large for gestational age were inconsistent. Five out eight studies reported lower rates of macrosomia in the weight loss surgery group. Two out of three studies observed similar rates of low birth weight in both groups. Three out of five studies indicated a higher risk of being small for gestational age in the weight loss surgery group. Two out of three studies reported lower rates of large for gestational age in the weight loss surgery group.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on birth weight (in categories)?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on gestational age?
- Conclusion
  The evidence reviewed found no difference in gestational age between infants born to women who had pregnancy after weight loss surgeries and those who had not (five out of seven studies). Similarly, no differences in pre-term birth between the two groups were noted (four out of five studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on gestational age?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on infant illnesses or complications such as perinatal mortality, NICU admissions, neonatal illness and congenital malformations rate?
- Conclusion
  The evidence reviewed observed no significant difference in perinatal death (four out of five studies), NICU admission (four out of five studies), illnesses during the neonatal period (one out of one studies) and congenital malformation rates (three out of four studies) between infants born to women who had pregnancy after weight loss surgeries and those who had not.
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on infant illnesses and complications, such as perinatal mortality, NICU admissions, neonatal illness and congenital malformations rate?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)
What are the health effects of pregnancy after weight loss surgery on infant APGAR score?
- Conclusion
  The evidence reviewed observed no significant differences in APGAR score or APGAR under seven at five minutes between infants born to women who had pregnancy after weight loss surgeries and those who had not (six out of six studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What are the health effects of pregnancy after weight loss surgery on infant APGAR score?
- Search Plan and Results: MIP: Weight Loss Surgery (2015)