161: The impact of class III obesity on maternal and neonatal outcomes in preeclamptic patients

Abstract

The rate of obesity is increasing in women of reproductive age, and obesity is a major risk factor for preeclampsia. Our objective was to compare maternal and neonatal morbidity and mortality in preeclamptic patients between those with a BMI <40 and a BMI ≥ 40 (class III obesity). We conducted a secondary analysis of a multicenter prospective cohort study (PE Triage by Rapid Assay-PETRA trial). The study’s primary objective was to validate placental growth factor as a biomarker for preeclampsia. Pregnant women at 200/7 to 400/7 weeks gestation who presented with signs or symptoms of preeclampsia (PE) were enrolled at 24 centers in the United States and Canada. The diagnosis of preeclampsia and other pregnancy complications were subsequently formulized by an adjudication group using standardized diagnostic criteria. Primary outcome was a composite neonatal morbidity (CNM) comprised of IVH (grade 3-4), NEC, BPD and perinatal death. Secondary outcomes were the components of CNM; small for gestational age (SGA) and gestational age at delivery (GA at del.) as well as maternal morbidity: abruption, renal failure, pulmonary edema, HELLP and eclampsia. Data were analyzed with the use of chi-square test and ANOVA as appropriate. 701 women with preeclampsia were evaluated: 585 (83%) had a BMI < 40 and 116 (17%) had a BMI ≥ 40. Baseline characteristics were different between groups regarding chronic hypertension and pre-gestational diabetes which were higher in those with a BMI ≥ 40 (Table 1). There were no significant differences in CNM between the 2 groups, however the BMI <40 subgroup had a higher rate of delivery at early and late preterm gestations (Table 2). Maternal morbidity was rare in both groups. In preeclamptic patients, maternal and neonatal morbidity is not increased in women with class III obesity. However, patients with class III obesity developed preeclampsia at a later gestational age.View Large Image Figure ViewerDownload Hi-res image Download (PPT)