{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:46:00Z","timestamp":1790675160319,"version":"4.1.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:sec id=\"ab-soi220082-4\"><jats:title>Importance<\/jats:title><jats:p>Metabolic and bariatric surgery (MBS) is the most efficient therapeutic option for severe obesity. Most patients who undergo MBS are women of childbearing age. Data in the scientific literature are generally of a low quality due to a lack of well-controlled prospective trials regarding obstetric, neonatal, and child outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-5\"><jats:title>Objective<\/jats:title><jats:p>To assess the risk-benefit balance associated with MBS around obstetric, neonatal, and child outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>The study included 53\u202f813 women on the French nationwide database who underwent an MBS procedure and delivered a child between January 2012 and December 2018. Each women was their own control by comparing pregnancies before and after MBS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-7\"><jats:title>Exposures<\/jats:title><jats:p>The women included were exposed to either gastric bypass or sleeve gastrectomy.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The study team first compared prematurity and birth weights in neonates born before and after maternal MBS with each other. Then they compared the frequencies of all pregnancy and child diagnoses in the first 2 years of life before and after maternal MBS with each other.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-9\"><jats:title>Results<\/jats:title><jats:p>A total of 53\u202f813 women (median [IQR] age at surgery, 30 [26-35] years) were included, among 3686 women who had 1 pregnancy both before and after MBS. The study team found a significant increase in the small-for-gestational-age neonate rate after MBS (+4.4%) and a significant decrease in the large-for-gestational-age neonate rate (\u221212.6%). The study team highlighted that compared with pre-MBS births, after MBS births had fewer occurrences of gestational hypertension (odds ratio [OR], 0.16; 95% CI, 0.10-0.23) and gestational diabetes for the mother (OR, 0.39; 95% CI, 0.34-0.45), as well as fewer birth injuries to the skeleton (OR, 0.27; 95% CI, 0.11-0.60), febrile convulsions (OR, 0.39; 95% CI, 0.21-0.67), viral intestinal infections (OR, 0.56; 95% CI, 0.43-0.71), or carbohydrate metabolism disorders in newborns (OR, 0.54; 95% CI 0.46-0.63), but an elevated respiratory failure rate (OR, 2.42; 95% CI, 1.76-3.36) associated with bronchiolitis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220082-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The risk-benefit balance associated with MBS is highly favorable for pregnancies and newborns but may cause an increased risk of respiratory failure associated with bronchiolitis. Further studies are needed to better assess the middle- and long-term benefits and risks associated with MBS.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2022.5450","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T16:01:30Z","timestamp":1668009690000},"page":"36","source":"Crossref","is-referenced-by-count":24,"title":["Risk-Benefit Balance Associated With Obstetric, Neonatal, and Child Outcomes After Metabolic and Bariatric Surgery"],"prefix":"10.1001","volume":"158","author":[{"given":"Claire","family":"Rives-Lange","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris-Cit\u00e9, F-75015, Paris, France"},{"name":"Assistance Publique-H\u00f4pitaux de Paris (AP-HP), Service de Nutrition, Centre Sp\u00e9cialis\u00e9 Ob\u00e9sit\u00e9, H\u00f4pital Europ\u00e9en Georges Pompidou, Paris, 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