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      AURORA: bariatric surgery registration in women of reproductive age - a multicenter prospective cohort study

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          Abstract

          Background

          The expansion of the obesity epidemic is accompanied with an increase in bariatric procedures, in particular in women of reproductive age. The weight loss induced by the surgery is believed to reverse the negative impact of overweight and obesity on female reproduction, however, research is limited to in particular retrospective cohort studies and a growing number of small case-series and case-(control) studies.

          Methods/design

          AURORA is a multicenter prospective cohort study. The main objective is to collect long-term data on reproductive outcomes before and after bariatric surgery and in a subsequent pregnancy. Women aged 18–45 years are invited to participate at 4 possible inclusion moments: 1) before surgery, 2) after surgery, 3) before 15 weeks of pregnancy and 4) in the immediate postpartum period (day 3–4). Depending on the time of inclusion, data are collected before surgery (T1), 3 weeks and 3, 6, 12 or x months after surgery (T2-T5) and during the first, second and third trimester of pregnancy (T6-T8), at delivery (T9) and 6 weeks and 6 months after delivery (T10-T11). Online questionnaires are send on the different measuring moments. Data are collected on contraception, menstrual cycle, sexuality, intention of becoming pregnant, diet, physical activity, lifestyle, psycho-social characteristics and dietary supplement intake. Fasting blood samples determine levels of vitamin A, D, E, K, B-1, B-12 and folate, albumin, total protein, coagulation parameters, magnesium, calcium, zinc and glucose. Participants are weighted every measuring moment. Fetal ultrasounds and pregnancy course and complications are reported every trimester of pregnancy. Breastfeeding is recorded and breast milk composition in the postpartum period is studied.

          Discussion

          AURORA is a multicenter prospective cohort study extensively monitoring women before undergoing bariatric surgery until a subsequent pregnancy and postpartum period.

          Trial registration

          Retrospectively registered (July 2015 - NCT02515214)

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          Most cited references37

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          Development, validation and utilisation of food-frequency questionnaires - a review.

          The purpose of this review is to provide guidance on the development, validation and use of food-frequency questionnaires (FFQs) for different study designs. It does not include any recommendations about the most appropriate method for dietary assessment (e.g. food-frequency questionnaire versus weighed record). A comprehensive search of electronic databases was carried out for publications from 1980 to 1999. Findings from the review were then commented upon and added to by a group of international experts. Recommendations have been developed to aid in the design, validation and use of FFQs. Specific details of each of these areas are discussed in the text. FFQs are being used in a variety of ways and different study designs. There is no gold standard for directly assessing the validity of FFQs. Nevertheless, the outcome of this review should help those wishing to develop or adapt an FFQ to validate it for its intended use.
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            Metabolic/bariatric surgery worldwide 2011.

            Metabolic/bariatric procedures for the treatment of morbid obesity, as well as for type 2 diabetes, are among the most commonly performed gastrointestinal operations today, justifying periodic assessment of the numerical status of metabolic/bariatric surgery and its relative distribution of procedures. An email questionnaire was sent to the leadership of the 50 nations or national groupings in the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Outcome measurements were numbers of metabolic/bariatric operations and surgeons, types of procedures performed, and trends from 2003 to 2008 to 2011 worldwide and in the regional groupings of Europe, USA/Canada, Latin/South America, and Asia/Pacific. Response rate was 84%. The global total number of procedures in 2011 was 340,768; the global total number of metabolic/bariatric surgeons was 6,705. The most commonly performed procedures were Roux-en-Y gastric bypass (RYGB) 46.6%; sleeve gastrectomy (SG) 27.8%; adjustable gastric banding (AGB) 17.8%; and biliopancreatic diversion/duodenal switch (BPD/DS) 2.2%. The global trends from 2003 to 2008 to 2011 showed a decrease in RYGB: 65.1 to 49.0 to 46.6%; an increase, followed by a steep decline, in AGB: 24.4 to 42.3 to 17.8%; and a marked increase in SG: 0.0 to 5.3 to 27.89%. BPD/DS declined: 6.1 to 4.9 to 2.1%. The trends from the four IFSO regions differed, except for the universal increase in SG. Periodic metabolic/bariatric surgery surveys add to the knowledge and understanding of all physicians caring for morbidly obese patients. The salient message of the 2011 assessment is that SG (0.0% in 2008) has markedly increased in prevalence.
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              The validation of the Edinburgh Post-natal Depression Scale on a community sample.

              The Edinburgh Post-natal Depression Scale (EPDS) was validated on a community sample of 702 women at six weeks post-partum using Research Diagnostic Criteria for depression. The estimates of sensitivity, specificity and positive predictive value, being based on a large random sample, offer improved guidelines for the use of the EPDS by the primary care team.
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                Author and article information

                Contributors
                goele.jans@med.kuleuven.be
                christophe.matthys@uzleuven.be
                belsarah@hotmail.com
                lieveke.amaye@kuleuven.be
                matthias.lannoo@uzleuven.be
                bart.vanderschueren@uzleuven.be
                bruno.dillemans@azbrugge.be
                luc@dr-lemmens.be
                jean.saey@chrmh.be
                yves.vanniewenhove@ugent.be
                Pascale.grandjean@chrmh.be
                ben_debecker@yahoo.com
                hilde.logghe@gmail.com
                marc.coppens@zna.be
                kristien.roelens@ugent.be
                anne.loccufier@azbrugge.be
                johan.verhaeghe@uzleuven.be
                roland.devlieger@uzleuven.be
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                29 July 2016
                29 July 2016
                2016
                : 16
                : 195
                Affiliations
                [1 ]Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
                [2 ]Department of Clinical and Experimental Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
                [3 ]Department of Endocrinology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
                [4 ]Scientific Institute of Public Health, Department of Public Health and Surveillance, Unit Surveys, Lifestyle and Chronic Diseases, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
                [5 ]Department of Abdominal Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
                [6 ]Department of Abdominal Surgery, St-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium
                [7 ]Department of Abdominal Surgery, St-Nikolaas Hospital, Moerlandstraat 1, 9100 St-Niklaas, Belgium
                [8 ]Medicosurgical unit for metabolic diseases, CHR Mons Hainaut, 5 avenue Baudouin de Constantinople, 7000 Mons, Belgium
                [9 ]Department of Gastrointestinal Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
                [10 ]Department of Obstetrics and Gynecology, CHR Mons Hainaut, 5 avenue Baudouin de Constantinople, 7000 Mons, Belgium
                [11 ]Department of Obstetrics, Gynecology and Reproduction, St-Augustinus Hospital Wilrijk, Oosterveldlaan 24, 2610 Wilrijk, Belgium
                [12 ]Department of Obstetrics and Gynecology, St-Lucas Hospital Bruges, St-Lucaslaan 29, 8310 Bruges, Belgium
                [13 ]Department of Obstetrics and Gynecology, ZNA Middelheim, Lindendreef 1, 2020 Antwerp, Belgium
                [14 ]Department of Obstetrics and Gynecology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
                [15 ]Department of Obstetrics and Gynecology, St-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium
                [16 ]Department of Obstetrics and Gynecology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
                Article
                992
                10.1186/s12884-016-0992-y
                4966861
                27473473
                0e0b6aba-7ebb-4186-a81b-7b741b2b0d27
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 August 2015
                : 19 July 2016
                Funding
                Funded by: Fundamenteel Klinisch Navorserschap FWO Vlaanderen
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2016

                Obstetrics & Gynecology
                obesity,bariatric surgery,reproduction,fertility,contraception,pregnancy,breast feeding

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