Adverse Maternal Outcomes in Obese Women With Severe Preeclampsia [31C

Abstract

INTRODUCTION: Our objective was to evaluate the rate of adverse maternal outcomes in obese compared to non-obese women with severe preeclampsia (PEC-S). METHODS: A retrospective cohort study of women greater or equal to 34 weeks gestation that were diagnosed with PEC-S from 2011-2013 was performed. Obesity was defined as BMI greater or equal to 30 kg/m2. PEC-S was defined by current guidelines from the American College of Obstetricians and Gynecologists. The primary outcome was a composite defined as one or more than the following: liver or renal failure, thrombocytopenia, abruption, blood transfusion, pulmonary edema, DIC, stroke, eclampsia, ICU admission. Chi-square analyses and Fishers exact test were used for categorical variables. Multivariable logistic regression was used to calculate odds. RESULTS: 193 women with PEC-S were included: 100 (51.8%) non-obese and 93 (48.2%) obese. Obese women were significantly less likely to have the composite outcome compared to non-obese women (9.7% vs. 21.0%, OR 0.40 [0.17-0.93], p=0.03). This decreased risk remained after adjusting for race, mode of delivery, and parity; aOR 0.38 [0.16-0.94], p=0.035. Within the composite outcome, obese women were less likely to have a blood transfusion (p=0.04) and had a non-significant lower risk of renal failure (p=0.13). Obese women were more likely to require IV antihypertensive medication (p=0.03) and to be discharged on oral antihypertensive medication (p=0.08) compared to non-obese women. CONCLUSION: Obese women with PEC-S have a lower risk of adverse maternal outcomes than non-obese women with PEC-S. This may reflect a different, less severe, phenotype for PEC-S in obese women compared to non-obese women and warrants further investigation.