Pregnancy Outcome in the Morbidly Obese: Black Versus White [37N

Abstract

INTRODUCTION: Obesity during pregnancy is associated with multiple known maternal and perinatal risks and these risks increase with increasing degrees of obesity. Racial disparities in obstetric outcome are well documented. Whether these two risk factors together further increase the chances of a poor outcome have not been studied. The purpose of this study was to compare the obstetric outcome of singleton pregnancies in morbidly obese black versus morbidly obese white women. METHODS: Morbid obesity (MO) was defined as a BMI greater than 40 at the time of delivery. Race was self-identified and recorded on admission. This was a retrospective study of all deliveries at our hospital from 12/14/2009 to 10/1/2013, total singleton deliveries: N = 45,961. Grp 1= Black MO, N = 1,236. Grp 2= White MO, N = 1,384. RESULTS: Based on our data, the addition of black race to morbid obesity increases the chances of poor obstetric outcome in all important measured variables except Cesarean delivery, labor induction and macrosomia. NICU admission was higher (N= 128 v N=104), Cord pH lower (7.25 ± .08 v 7.26 ± .08) and birth weight lower (3103 ± 734 v 3383 ± 710 g) between Grp 1 and Grp 2, respectively, P less than .05. CONCLUSION: This study suggests that black MO pregnant women are at greater risk of poor obstetric outcome than white women possibly based on their race.