Impact of bariatric surgery on anthropometric, metabolic, and reproductive outcomes in polycystic ovary syndrome: a systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in females. Modest weight loss improves reproductive and metabolic PCOS features. While lifestyle modifications and pharmacotherapies remain first-line weight loss strategies, bariatric surgery is emerging as a potentially effective treatment. We performed a systematic review and meta-analysis of published literature to examine the impact of bariatric surgery in PCOS to inform the 2023 International PCOS Evidence-based Guidelines. Electronic databases were searched for observational studies and trials comparing pharmacologic or lifestyle treatments to bariatric surgery in women with PCOS or bariatric surgery in women with or without PCOS. Anthropometric, reproductive, hormonal, and metabolic outcomes were included and, where possible, meta-analyzed using random-effects models. Risk of bias and evidence quality were assessed. Ten studies were included involving 432 women with and 590 women without PCOS. Comparisons between bariatric surgery and pharmacologic or lifestyle treatments were only reported in one study each, and most reproductive outcomes were limited to a single study; therefore, meta-analyses could not be performed. Meta-analysis found that women with PCOS experience similar improvements in anthropometric, hormonal, and metabolic outcomes after bariatric surgery compared to those without PCOS. Existing research is limited and of low quality with high risk of bias, especially in comparison to existing PCOS treatments and with respect to reproductive outcomes including pregnancy, highlighting the need for additional studies to inform clinical recommendations.

Explaining infant feeding style of low-income black women

Unstructured interviews were conducted with 10 low-income black women to explore infant feeding style. Formula-feeding with early introduction of cereal in the bottle was the most common pattern used by mothers in the first 3 months. By 6 months, formula-fed infants had a complex diet of a variety of foods. Half the women intended to breast-feed, but only one exclusively breast-fed. Beliefs about healthy infants and crying influenced feeding. There was a lack of knowledge about and support for breast-feeding in these women's environment. Support and advice about infant feeding from the health care system were uneven.

Infant feeding styles of West Indian women

An ethnographic field study design was used to explore infant feeding among 20 West Indian women on the island of St. Croix, United States Virgin Islands. Two styles of infant feeding emerged from the data, "older style" and "contemporary style." Three patterns of combined breast and bottle feeding were identified: day/night, supplemental, and random. Older style mothers followed a day/night pattern, whereas contemporary style mothers used a supplemental pattern. A folk explanatory model of infant feeding was constructed and included why infants were fed in certain ways, as well as the meaning of feeding practices. The health care system had an impact on both styles of infant feeding through hospital practices and provision of formula through the Women, Infants, and Children (WIC) program.