Pregnancy Outcomes Following Different Types of Bariatric Surgery: A Network Meta-Analysis

The increasing number of women of reproductive age undergoing bariatric surgery has brought more attention to pregnancies following these procedures. However, the impact of different types of bariatric surgery on pregnancy outcomes remains unclear. This study aims to systematically investigate the effects of four types of bariatric surgery-Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and biliopancreatic diversion (BPD)-on pregnancy outcomes. A total of 29 studies were included. Different types of bariatric surgeries exhibit distinct risk-benefit profiles concerning pregnancy outcomes, which should guide personalized surgical decisions for women of reproductive age. For the majority of women planning pregnancy, SG appears to present the most balanced risk-benefit profile. LAGB may be considered when concerns regarding fetal growth outweigh the need for metabolic improvement. For women with specific metabolic conditions, BPD could be contemplated following a thorough risk-benefit assessment, accompanied by intensive prenatal monitoring and nutritional support. Future research should investigate the optimal timing between surgery and conception, develop comprehensive nutritional monitoring protocols, and conduct individual patient data meta-analyses to enhance the personalization of recommendations.