the contribution of early previable live births (
Poster Session IV
ajog.org treated hypoglycemia (aOR 6.1, 95% CI 3.0-12.7). However, the incidence of the neonatal and maternal composites was not different between women with both cHTN and DM as compared to those with DM alone. CONCLUSION: Our findings suggest that both cHTN and DM individually increase the incidences of selected adverse neonatal and maternal outcomes in women with class III obesity. The combination of these comorbidities, however, does not increase neonatal morbidity above what is observed with DM alone.
739 The additive effects of chronic hypertension and pregestational diabetes mellitus on neonatal and maternal outcomes in women with class III obesity undergoing a pre-labor repeat cesarean delivery Spencer G. Kuper, Melissa N. Gazi, Duncan T. Harmon, Jeff M. Szychowski, Alan T. Tita, Akila Subramaniam University of Alabama at Birmingham, Center for Women’s Reproductive Health, Department of Obstetrics and Gynecology., Birmingham, AL
OBJECTIVE: Class III obesity (BMI 40), chronic hypertension
(cHTN), and pregestational diabetes (DM) are individually associated with adverse perinatal outcomes; however, additive and cumulative risks of these comorbidities are not clear. We sought to determine if cHTN, DM, or a the combination of the two, increases the risks of adverse neonatal and maternal outcomes in women with class III obesity undergoing a pre-labor repeat cesarean delivery (RCD) at term. STUDY DESIGN: We performed a secondary analysis of a prospective cohort of patients undergoing a RCD at term in 19 academic centers from 1999-2002. All women with class III obesity with and without comorbidities (specifically, cHTN and/or DM) who delivered term non-anomalous viable singletons by pre-labor RCD were included. Women with other comorbidities (e.g. preeclampsia, IUGR) were excluded. Outcomes included composite neonatal and maternal outcomes as well as their individual components. Multivariable logistic regression was used to adjust for confounding variables with class III obesity without comorbidities selected as reference; results were presented as odds ratios with 95% confidence intervals (CI). RESULTS: Of the 24077 women who had a term pre-labor RCD, 2136 were analyzed. The incidence of both the neonatal and maternal composite (and select components) was higher for class III obese women with either DM or cHTN as compared to those without these comorbidities, with this effect more pronounced for women with DM (figure). Only class III obese women with DM had a significantly increased risk of the neonatal composite outcome (aOR 2.6, 95% CI 1.8-3.7), NICU admission (aOR 3.2, 95% 2.2-4.7), and
740 Contribution of previable infant deaths to infant mortality rates among US census regions MacKenzie Z. Lee1, Eric Hall2, Meredith Taylor1, Emily DeFranco3 1
University of Cincinnati College of Medicine, Cincinnati, OH, 2Cincinnati Children’s Hospital, Cincinnati, OH, 3University of Cincinnati, Department of Maternal Fetal Medicine, Cincinnati, OH
OBJECTIVE: Variation in reporting of early gestation births has the
potential to influence infant mortality rate (IMR) calculations and affect regional IMR comparisons. We aim to quantify differences in the contribution of early previable live births (
