(955) Obesity and maternal complication trends from 2015-2020

Maternal obesity is associated with an increased risk of maternal morbidity.  The primary objective of this study is to evaluate the trend in maternal morbidity from 2015-2020 in obese pregnant women.

Study Design:

This is a retrospective study using the U.S. Natality Data from 2015-2020 including births from 20-42 weeks gestation.  A total of 20,629,082 patients were identified.  Patients were further stratified by weight class including underweight (BMI < 18.5 kg/m²), normal (BMI 18.5-24.9 kg/m²), overweight (BMI 25-29.9 kg/m²), class 1 obesity (BMI 30-34.9 kg/m²), class 2 obesity (BMI 35-39.9 kg/m²) and class 3 obesity (BMI > 40 kg/m²). Maternal outcomes of interest included intensive care unit (ICU) admission, gestational hypertension, eclampsia, transfusion requirement, cesarean hysterectomy, and cesarean section. Trends in maternal complications from 2015-2020 were determined for each weight class utilizing weighted least squares regressions.

Results:

From 2015-2020, there was a statistically significant trend towards increasing maternal ICU admission in the class 2 obesity group as well as the normal and overweight groups.  All weight classes, including all three obesity groups, demonstrated a similar increasing trend in gestational hypertension (Figure 1) and transfusion requirement (Figure 2), as well as a decreasing trend in cesarean section.  None of the obesity classes demonstrated a statistically significant trend in eclampsia but the underweight, normal, and overweight groups had an increasing trend over the five years.  Only the overweight class had an increasing trend in cesarean hysterectomy while all obesity classes did not demonstrate such a trend.

Conclusion:

In obese pregnant patients from 2015-2020, there is a trend to suggest an increasing rate of maternal complications including gestational hypertension, transfusion requirement, and ICU admission as well as a trend suggesting a decreasing rate of cesarean section.