(608) Stratification of body mass indices over 40 and length of stay during labor

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: Obesity is associated with increased maternal and fetal morbidity and mortality. There has been little research looking at length of hospital stay in relationship to Body Mass Index (BMI). Longer length of stay not only increases health care costs but it also increases the risk of infection and venous thromboembolism. It is hypothesized that there is a direct correlation between increasing BMI and length of stay during admission for labor and delivery.

Study Design: This is a large retrospective, single center, cohort study with 5 hospital sites. All pregnancies between the years of 2014-2022 were evaluated. Exclusion criteria included multiple fetal gestations, patients without a listed BMI, and fetal demises. Data was extracted using EPIC electronic medical record. BMI classes were stratified as 18.5-24.9 (1), 25-29.9 (2), 30-34.9 (3), 35-39.9 (4), 40-49.9 (5), 50-59.9 (6), 60-69.9 (7), and 70-80 (8). Within these categories, we looked at length of stay during the patient's delivery admission, maternal intensive care unit (ICU) admissions and neonatal intensive care unit (NICU) admissions.

Results: After analyzing 67,722 pregnancies it was found that there is a positive correlation between increasing BMI and length of stay. There was a statistically significant difference between maternal ICU admissions particularly in BMI’s of 70-80 when compared to BMIs < 70 (p < 0.05). Admissions to the NICU increased as the BMI increased past 40 mg/kg2, however these findings were not statistically significant.

Conclusion: This study demonstrates a positive correlation between increasing BMI and length of stay, maternal ICU admission rate, as well as NICU admission rate. These findings should reiterate the importance of a multidisciplinary care approach for patients with morbid obesity. This data can aide with counseling obese patients appropriately during both pre-conception, prenatal, and post partum visits.

Primary & Presenting Author(s)

Shelby Masters, MD
Henry Ford Health
Detroit, Michigan, United States

Coauthor(s)

Nicolina Smith, DO, MBA, MS
Obstetrics and Gynecology Resident
Henry Ford Health System
Detroit, Michigan, United States

D'angela S. Pitts, MD
Maternal Fetal Medicine Attending
Henry Ford Health System
Detroit, Michigan, United States