628 Obstetric and neonatal outcomes stratified by higher levels of superobesity

Abstract

Maternal superobesity (body mass index [BMI] ≥50) is increasing in the United States. However, there is limited data describing neonatal outcomes with stratification higher than a body mass index (BMI) >50. The objective of this study was to determine if there is a dose dependent increase in obstetric and neonatal adverse outcomes at higher levels of BMI in superobese women. This is a retrospective cohort study of obese pregnant women with singleton gestations who delivered at a single academic institution between 2000-2019 with BMI at delivery and neonatal outcomes available for analysis. Superobese women were stratified by BMI 50-59.9, 60-69.9, and ≥70 at time of delivery. Multivariate logistic regression was performed to calculate adjusted odds ratios (aOR) for individual obstetric and composite neonatal outcomes comparing higher levels of superobesity as well as overall superobesity compared to women with class I obesity (BMI 30-34.9). 12,373 pregnant women were included in the study. Of these women, 1,470 were superobese (1,184 with BMI 50-59.9, 230 with BMI 60-69.9 and 56 with BMI ≥70). When compared to class I obese parturients, superobese women were more likely to have higher baseline co-morbid illness (Table 1). Overall, superobese women had a higher probability of obstetric complications including preeclampsia (aOR 2.66; CI 2.29-3.09), preterm birth (aOR 1.26; CI 1.10-1.43), and cesarean delivery (aOR 3.02; CI 2.69-3.39). Neonates of superobese women were more likely to be LGA (aOR 2.01; CI 1.72-2.34), have an Apgar <7 at 5 minutes (aOR 1.54; CI 1.27-1.86), and experience mild (aOR 1.72; CI 1.52-1.94), but not severe (aOR 0.91; CI 0.73-1.11), composite neonatal morbidity. No significant differences were found for the studied outcomes when superobesity was further stratified above BMI>50 (Table 2). Compared to their less obese counterparts, superobese pregnant women are at increased risk of adverse obstetric and neonatal outcomes. However, there does not appear to be additional risk with higher stratified levels of BMI >50 in women with superobesity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)