Severe Maternal Morbidity and Mortality During Delivery Hospitalization of Class I, II, III, and Super Obese Women
ACOG ePoster. Platner M. Apr 27, 2018; 212097
Marissa Platner
Marissa Platner
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Abstract
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Introduction: Previous studies show that obesity predisposes patients to higher risks of adverse pregnancy outcomes. Data on the relationship between increasing degrees of obesity and risks of severe maternal morbidity, including mortality (SMM), are limited. The purpose of this study was to examine the association of different classes of obesity with SMM during delivery hospitalization.

Methods: Using New York City linked birth certificates and hospital discharge data, this study identified delivery hospitalizations for singleton, live births from 2008 through 2012. Women were classified as obese (Class I, II, III or super obesity), as opposed to normal weight or overweight, based on pre-pregnancy body mass index (BMI). Cases of SMM were identified based on ICD-9 diagnosis and procedure codes according to CDC criteria. Multivariable logistic regression was used to evaluate the association between obesity classes and SMM, adjusting for maternal socio-demographic and medical comorbidities.

Results: There were 539,870 live singleton births with available information on pre-pregnancy BMI. After adjusting for maternal characteristics, women with Class I (adjusted odds ratio (aOR) 1.07; 95% confidence interval (CI) 1.02-1.13), Class II (1.13; 1.05-1.21), Class III (1.26; 1.15-1.38), and super obesity (1.68; 1.32-2.11) were all significantly more likely to have SMM compared to normal and overweight women. Increasing BMI was associated with specific SMM indicators including: renal failure, blood transfusion, and heart failure in the adjusted analysis.

Conclusion/Implications: There is a significant dose-response relationship between increasing obesity class and risk of SMM at delivery hospitalization. This relationship persisted even after accounting for potential confounding effects of comorbid conditions.
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