Is Obesity Associated With Pregnancy Related Deaths? A Michigan Experience [12I]

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Abstract

INTRODUCTION:

The negative impact of obesity in pregnancy is well documented. The study was conducted to determine the association between maternal obesity (body mass index at or above 30 kg/m2) BMI and pregnancy related deaths (PRD).

METHODS:

Secondary analysis of PRDs as determined by the Michigan Maternal Mortality Review Committee utilizing birth-death linked certificates and de-identified maternal medical records review.

RESULTS:

384,765 live births occurred in the state during the study period. 205 maternal deaths were identified, 67 (32.7%) were classified as PRD. 95% of the PRDs occurred during or within 42 days from the end of the pregnancy. 53.7% of the PRDs occurred in obese patients, 37.3% of PRDs on non-obese women. This translates into a maternal mortality ratio of 34.1/100,000 in obese women and 9.0/100,000 in non obese women or 3.7 times the risk of PRD in obese pregnant woman. The maternal mortality ratio for PRDs in the USA during the study period was 15.5/100,000, in Michigan 17.4/100,000.

CONCLUSION:

Clinically marked difference is demonstrated between the PRDs in the obese versus the non obese pregnant women. The obese pregnant or recently pregnant woman has a substantially higher risk of death than her non obese counterpart. 30% of the obese women that died were black while 22% were non black. Black obese pregnant women showed 38% chronic cardiovascular disease versus 24% in the non black population. Future research must address practitioner and population education to achieve preconception recommended BMI to decrease maternal severe morbidity and mortality.

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