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Discussion Board 8



locate a recent research study (published within the previous five years) that examined a pharmacological or surgical treatment for obesity (not a psychotherapeutic or behavioral treatment). Summarize the purpose, method and results of the research for your peers. Be sure to include an APA style citation and reference.

You might be interested in the following articles as you consider this discussion prompt.

Akhter, Z, Rankin, J., Ceulemans, D., Ngongalah, L., Ackroyd, R., Devlieger, R., Vieira, R., & Heslehurst, N. (2019). Pregnancy after bariatric surgery and adverse perinatal outcomes: A systematic review and meta-analysis. PLoS Medicine, 16(8), e1002866.
Khorgami, Z., Shoar, S., Saber, A.A., Howard, C.A., Danaei, G., & Sclabas, G.M. Outcomes of bariatric surgery versus medical management for Type 2 Diabetes Mellitus: A meta-analysis of randomized controlled trials.Obesity Surgery, 29(3), 964-974.
Pedroso, F.E., Angriman, F., Endo, A., Dasenbrock, H., Storino, A., Castillo, R., ... & Zitsman, J. (2018). Weight loss after bariatric surgery in obese adolescents: A systematic review and meta-analysis. Surgery for Obesity and Related Diseases, 14(3), 413-422.











Manage Discussion Entry 

      There are three types of bariatric surgery, gastric bypass, sleeve, and adjustable gastric banding. This author was informed to summarize an article on the subject of bariatric surgery. The subject chosen was the association between bariatric surgery and pregnancy.
    Akhter et al. (2019) advance that women who have bariatric surgery before pregnancy are less probably to have associated difficulties with obesity. Associated difficulties may include but are not limited to gestational diabetes and hypertension. Nevertheless, bariatric surgery can engender patients to be vulnerable to nutritional deficiencies that are seminal to healthy fetal development. Akhter et al. (2019) advance a systematic conspectus and meta-analysis to explore the association between pregnancy and bariatric surgery regarding adverse perinatal outcomes.
      The process for the study was to initially conduct searches on Medline, Embase, PsychINFO, CINAHL, Scopus, and Google Scholar from initiation until June of 2019. This was accompanied by searching reference lists by hand, citations, and journals. Additionally, observational studies regarding the comparison of results of post-bariatric surgery to those pregnancies without bariatric surgeries were also incorporated. The results focused on perinatal mortality, congenital anomalies, pre and post-term birth, gestational age for both small (SGA) and large (LGA), and neonatal intensive care unit (NICU) admission. If the information was available, the outcomes were sub-grouped by the different types of bariatric surgeries. Included in this analysis were 33 studies that contained 14,880 pregnancies after bariatric surgery with 3,979,978 controls. In terms of odds ratios, which is a measure of association between an exposure and an outcome, the research (Akhter et al., 2019) indicated:
Odds ratios (ORs) were increased after bariatric surgery (all types combined) for perinatal mortality (1.38, 95%          confidence interval [CI] 1.03-1.85, p = 0.031), congenital anomalies (1.29, 95% CI 1.04-1.59, p = 0.019), preterm    birth (1.57, 95% CI 1.38-1.79, p < 0.001), and NICU admission (1.41, 95% CI 1.25-1.59, p < 0.001). Post-term birth decreased after bariatric surgery (OR 0.46, 95% CI 0.35-0.60, p < 0.001).
    Odds ratios for SGA went up, while LGA decreased only after gastric bypass surgery, but not after gastric banding. In considering the weight of babies after bariatric surgery, they weighed on average over 200 g less than babies born to mothers without prior bariatric surgery. There were some limitations advanced regarding this study. As it is a meta-analysis of studies that had already taken place, the outcomes are inherently limited to by the standards and quality of those studies already done. This would include the available data, any confounders not measured, and the small number of studies for certain outcomes.
    In summation, bariatric surgery, especially gastric bypass, before pregnancy was linked to a higher risk of adverse outcomes. This intimates that women who have had bariatric surgery may require preconception and pregnancy support in nutrition and monitoring on fetal development. Future studies are suggested to learn if restrictive surgery engenders better perinatal results compared to malabsorptive (a condition that prevents absorption of nutrients) surgery.
Reference
Akhter, Z., Rankin, J., Ceulemans, D., Ngongalah, L., Ackroyd, R., Devlieger, R., Viera, R., & Heslehurst, N. (2019). Pregnancy after bariatric surgery and adverse perinatal outcomes: A systematic review and meta-analysis. PLoS medicine, 16(8).