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Am J Perinatol 2019; 36(01): 074-078
DOI: 10.1055/s-0038-1661403
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adverse Maternal Outcomes Differ between Obese and Nonobese Women with Severe Preeclampsia

Christina Paidas Teefey
1   The Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine – University of Pennsylvania, Philadelphia, Pennsylvania
,
Celeste P. Durnwald
1   The Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine – University of Pennsylvania, Philadelphia, Pennsylvania
,
Sindhu K. Srinivas
1   The Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine – University of Pennsylvania, Philadelphia, Pennsylvania
,
Lisa D. Levine
1   The Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine – University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Funding This study was funded in part by a career development award in Women's Reproductive Health Research: K12-HD001265–15.
Further Information

Publication History

14 March 2018

21 May 2018

Publication Date:
06 July 2018 (online)

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Abstract

Objective This article evaluates the differences in adverse maternal outcomes related to severe preeclampsia in obese versus nonobese women.

Study Design Retrospective cohort study and planned secondary analysis of women with severe preeclampsia comparing a composite adverse maternal outcome related to preeclampsia among obese (body mass index [BMI] ≥ 30 kg/m2) and nonobese (BMI < 30 kg/m2) women. The composite outcome was defined as ≥ 1 of the following prior to discharge: renal failure, liver abnormality, thrombocytopenia, blood transfusion, pulmonary edema, disseminated intravascular coagulation, stroke, or eclampsia. Multivariable logistic regression was used to control for confounders.

Results Of the 152 women included, 37.5% were obese and 62.5% were nonobese. The prevalence of the primary outcome was 15.8% with obese women less likely to have the composite outcome compared with nonobese women (7% vs. 21.1%, p = 0.02). This remained after adjusting for confounders including maternal age, race, and chronic hypertension (adjusted odds ratio, 0.33 [0.12–0.89], p = 0.03). Obese women were, however, more likely to require intravenous antihypertensive medication peripartum compared with nonobese women (49.1% vs. 28.4%, p = 0.01).

Conclusion Obese women with severe preeclampsia may have a different phenotype of severe preeclampsia that is more associated with severe hypertension rather than end-organ damage.

Keywords

obesity - severe preeclampsia - preeclampsia with severe features - adverse maternal outcome - phenotype

Note

This article was presented as a poster at the American College of Obstetricians and Gynecologists in San Diego, CA, in May of 2017.