{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:07:08Z","timestamp":1791205628791,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the independent and combined associations of metabolic and bariatric surgery (MBS) and gestational diabetes mellitus (GDM) with adverse maternal and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population\u2010based retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>New South Wales (NSW), Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Four hundred twenty\u2010nine thousand five hundred seventy\u2010six singleton births from 2016 to 2020 in NSW, including 3001 women with a history of MBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Linked perinatal and hospital data were used to classify women into four groups: no MBS\/no GDM, MBS\/no GDM, GDM\/no MBS, and GDM\/MBS. Multivariable logistic regression was used to examine associations with adverse outcomes, adjusting for maternal age, BMI, parity, smoking, country of birth, and gestational age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Neonatal and maternal outcomes including preterm birth, (large\u2010for\u2010gestational\u2010age) LGA, small\u2010for\u2010gestational\u2010age (SGA), neonatal hypoglycaemia, preeclampsia and postpartum haemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women with both GDM and prior MBS had the highest odds of adverse outcomes. Compared to women without GDM or surgery, this group had increased odds of LGA (aOR 1.42, 95% CI 1.22\u20131.65), preterm birth (aOR 1.93, 95% CI 1.52\u20132.42), and neonatal hypoglycaemia (aOR 4.98, 95% CI 4.22\u20135.84). Preeclampsia risk was modestly increased across all groups but attenuated after BMI adjustment. Postpartum haemorrhage was reduced in women with prior surgery (aOR 0.81, 95% CI 0.72\u20130.92), while induction of labour was more likely in all exposure groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>gestational diabetes mellitus (GDM) and prior MBS confer independent and combined risks for adverse perinatal outcomes. These findings support the need for personalised antenatal care strategies in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70226","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T07:26:16Z","timestamp":1774337176000},"page":"1753-1761","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bariatric Surgery, Gestational Diabetes and Perinatal Outcomes: A Population\u2010Based Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9663-2624","authenticated-orcid":false,"given":"Tessa","family":"Weir","sequence":"first","affiliation":[{"name":"Kolling Institute, Northern Sydney Local Health  Sydney New South Wales Australia"},{"name":"Department of Endocrinology Nepean Blue Mountains Hospital, Western Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6024-2958","authenticated-orcid":false,"given":"Ibinabo","family":"Ibiebele","sequence":"additional","affiliation":[{"name":"Kolling Institute, Northern Sydney Local Health  Sydney New South Wales Australia"},{"name":"Reproduction and Perinatal Centre Northern Precinct, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Randall","sequence":"additional","affiliation":[{"name":"Reproduction and Perinatal Centre Northern Precinct, Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Clinical Excellence Commission NSW Health  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Nippita","sequence":"additional","affiliation":[{"name":"Reproduction and 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