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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(572) Racial and ethnic disparities in severe maternal morbidity and ICU admission by bariatric surgery status

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: To assess racial and ethnic disparities in severe maternal morbidity (SMM) and ICU admission in patients with and without a history of bariatric surgery.

Study Design: Retrospective cohort study of pregnancies within a large health care system in New York from 2019-2023. The primary exposure was bariatric surgery, which included: gastric sleeve, gastric band, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. Race and ethnicity were self-identified from pre-specified categories. The primary outcome was SMM during delivery hospitalization. SMM was defined using the Centers for Disease Control and Prevention (CDC) criteria which includes 21 indicators. A multivariable logistic regression was used to estimate the strength of association between prior bariatric surgery and SMM and ICU admission, adjusting for Obstetric Comorbidity Index (OBCMI) and race and ethnicity group. All statistical analyses were performed in R 4.3.1.

Results: In total, 127,959 pregnancies with delivery outcomes were identified with 493 (0.4%) with and 127,466 (99.6%) without a history of bariatric surgery. SMM occurred in 43 (8.7%) of pregnancies with a history of bariatric surgery and in 5,333 (4.2%) of pregnancies without such a history [unadjusted OR: 2.19, 95% CI 1.58-2.96]. After adjustment for OBCMI and race and ethnicity groups, no significant differences among SMM in patients with a history of bariatric surgery was observed [aOR: 1.37, 95% CI 0.98-1.88]. ICU admission occurred in 12 (2.4%) pregnancies with a history of bariatric surgery and in 797 (0.6%) pregnancies without such a history [aOR: 2.13, 95% CI 1.11-3.71]. All other race and ethnicity groups were at increased risk for SMM compared to Non-Hispanic White patients (Table 1).

Conclusion: A history of bariatric surgery was associated with increased risks of SMM before, but not after, adjustments for OBCMI and race and ethnicity group. ICU admission was significantly increased even after adjustments. Significant differences in SMM were seen by race and ethnicity group.