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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 1

(121) Impact of Obesity Class on Severe Maternal Morbidity in Pregnancies with Postpartum Hemorrhage

Thursday, January 30, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Allison N. Akers, MD (she/her/hers)

    Department of Obstetrics & Gynecology, University of South Florida Morsani College of Medicine
    Tampa, Florida, United States

    • Coauthor(s)

  • LM

    Lilla Markel, MD

    Department of Obstetrics & Gynecology, University of South Florida Morsani College of Medicine
    Tampa, Florida, United States

  • SA

    Shreya Arora, BS

    University of South Florida Morsani College of Medicine
    TAMPA, Florida, United States

  • SS

    Sydney Stewart, BS

    University of South Florida Morsani College of Medicine
    Tampa, Florida, United States

  • Jose R. Duncan, MD (he/him/his)

    Associate Professor
    Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine
    Tampa, Florida, United States

  • Judette M. Louis, MD

    Department Chair
    Department of Obstetrics & Gynecology, University of South Florida Morsani College of Medicine
    University of South Florida, Florida, United States

Objective: Prior studies have reported a need for more doses of uterotonic agents when managing postpartum hemorrhage in patients with obesity. We sought to evaluate the association between obesity severity on postpartum hemorrhage interventions and associated severe maternal morbidity (SMM).

Study Design:

We conducted a retrospective cohort study including all singleton gestations among women who delivered at a safety net quaternary care center from January 2019-December 2021. Medical charts were reviewed for clinical and sociodemographic data. Patients with multiple gestation or incomplete data were excluded. Obstetric hemorrhage was defined as quantitative blood loss ≥1000 mL in vaginal or cesarean deliveries. CDC severe morbidity indicators and nonsurgical and surgical hemorrhage interventions were assessed. There were three comparative groups based on prepregnancy BMI: BMI ≤29kg/m2 (Group 1), 30-39 kg/m2 (Group 2), and ≥ 40kg/m2 (Group 3). The data were analyzed using chi-square, student’s t-test, Kruskal-Wallis, and logistic regression where appropriate. p < 0.05 was significant.

Results: During the study period there were 18,937 deliveries and 393 met criteria for inclusion in this analysis. Within the study cohort, 57.0% (n=224) were in Group 1, 28.0% (n=111) in Group 2, and 14.8% (n=58) in Group 3. Patients in each group were similar in demographic characteristics but were more likely to have hypertensive disease (Table 1).   After controlling for confounding variables, obesity class (OR. 0.7[95% CI 0.5-1.0]) was not associated with an increased odds of SMM. Higher admission hemoglobin (OR 0 .7 [95%CI .65-.9] was protective against SMM. In contrast, preterm delivery (OR 2.3 [95%CI 1.3-4.4] and number of hemorrhage risk factors (OR1.5 [95%CI 1.2-1.9]) were associated with a higher odds of SMM.

Conclusion: In this cohort of patients managed with a standardized hemorrhage management protocol, obesity severity was not associated with severe maternal morbidity.