669: Maternal and perinatal complications of super-obesity (BMI at least 50.00 kg/m2)

Abstract

To evaluate the effects of super-obesity (prepreg BMI at least 50.00kg/m2) in pregnancy on maternal and perinatal outcomes. A population-based cohort study using the Newfoundland and Labrador Perinatal Database evaluated obstetric outcomes in women with singleton gestations giving birth Jan 1, 2001 to Dec 31, 2011, comparing women with super-obesity to those with a normal BMI (prepreg BMI 18.50-24.99 kg/m2). Outcomes of interest included maternal and perinatal outcomes. A composite morbidity outcome was developed including at least one of Cesarean Section (CS), gestational hypertension, birthweight(BW) >4000g, BW <2500g, or NICU admission. Univariate analyses and multivariate logistic regression analyses (controlling for maternal age, parity, smoking, partner status and gestational age) were performed and odds ratios (ORs) and 95% confidence intervals(CI) were calculated. A total of 5788 women were included in the study - 71 with super-obesity and 5717 with a normal BMI. 6 per 1000 women giving birth in our population have super-obesity. These women were more likely to have gestational hypertension (19.7% vs 4.8%)(OR=1.56, 95% CI 1.33-1.82), gestational diabetes (21.1% vs 1.5%)(OR=2.04, 95% CI 1.74-2.38), shoulder dystocia (7.1% vs 1.4%)(OR=1.51, 95% CI1.05-2.19), CS (60.6% vs 25.0%)(OR=1.46, 95% CI 1.29-1.65), length of hospital stay more than 5 days(excluding CS) (14.3% vs 4.7%)(OR=1.42, 95% CI 1.07-1.89), BW >4000g (38.0% vs 11.9%)(OR=1.58, 95% CI 1.38-1.80), BW >4500g (16.9% vs 2.1%)(OR=1.87, 95% CI 1.57-2.23), neonatal metabolic abnormality (8.5% vs 2.0%)(OR=1.50, 95% CI 1.20-1.86), NICU admission (16.9% vs 7.8%)(OR=1.28, 95%CI 1.07-1.52), stillbirth (1.4% vs 0.2%)(OR=1.68, 95%CI 1.00-2.82) and composite adverse outcome (81.7% vs 41.5%)(OR=1.57, 95%CI 1.35-1.83). Super-obese women have increased risks of a variety of adverse maternal and perinatal outcomes. It is important preconceptually to address these risks with such women and encourage a healthy BMI prior to pregnancy.