TABLE 2.
Adjusted odds ratiosa of severe maternal morbidity with and without transfusion by prepregnancy body mass index
| SMM | Underweight (BMI <18.5), aOR (95% CI) | Class I obesity (BMI 30–34.9), aOR (95% CI) | Class II obesity (BMI 35–39.9), aOR (95% CI) | Class III obesity (BMI 40–49.9), aOR (95% CI) | Super obesity (BMI ≥50), aOR (95% CI) |
|---|---|---|---|---|---|
| Acute renal failure | 1.24 (0.75–2.04) | 1.26 (0.92–1.72) | 1.32 (0.84–2.08) | 2.01 (1.22–3.32)b | 4.42 (1.80–10.81)b |
| Adult respiratory distress syndrome | 0.72 (0.39–1.32) | 0.94 (0.67–1.31) | 1.41 (0.93–2.14) | 2.08 (1.31 –3.30)b | 1.56 (0.39–6.29) |
| Disseminated intravascular coagulation | 0.77 (0.55–1.09) | 0.79 (0.63–1.00) | 1.06 (0.78–1.45) | 0.75 (0.45–1.23) | 1.16 (0.37–3.62) |
| Eclampsia | 0.86 (0.45–1.63) | 1.05 (0.71 –1.56) | 0.79 (0.40–1.55) | 2.46 (1.44–4.21)b | 1.28 (0.18–9.19) |
| Heart failure during procedure or surgery | 0.58 (0.14–2.41) | 1.52 (0.82–2.82) | 2.37 (1.11 –5.07)b | 4.95 (2.38–10.29)b | 13.68 (4.17–44.87)b |
| Puerperal cerebrovascular disorders | 0.87 (0.35–2.14) | 0.65 (0.36–1.20) | 0.41 (0.13–1.29) | 2.02 (0.97–4.20) | 3.96 (0.96–16.25) |
| Pulmonary edema or acute heart failure | 0.27 (0.08–0.83) | 1.07 (0.74–1.53) | 1.51 (0.95–2.39) | 2.38 (1.45–3.90)b | 1.94 (0.48–7.88) |
| Severe anesthesia complications | 1.41 (0.61–3.27) | 1.95 (1.17–3.25)b | 2.52 (1.28–4.96)b | 3.85 (1.82–8.15)b | 4.13 (0.57–30.09)b |
| Sepsis | 0.94 (0.51 –1.74) | 1.63 (1.17–2.27)b | 1.48 (0.89–2.45) | 2.25 (1.29–3.91)b | 1.21 (0.17–8.69) |
| Air and thrombotic embolism | 1.22 (0.57–2.65) | 1.14 (0.71–1.82) | 1.42 (0.76–2.67) | 1.69 (0.78–3.67) | 5.61 (1.76–17.90)b |
| Blood transfusion | 0.93 (0.82–1.05) | 1.03 (0.95–1.11) | 1.11 (0.99–1.24) | 1.23 (1.07–1.43)b | 1.74 (1.24–2.45)b |
| Hysterectomy | 0.74 (0.46–1.21) | 0.96 (0.74–1.26) | 1.24 (0.86–1.78) | 1.29 (0.79–2.12) | 1.85 (0.59–5.81) |
| Ventilation | 0.77 (0.28–2.11) | 1.1 (0.64–1.86) | 1.58 (0.81 –3.08) | 4.25 (2.41 –7.49)b | 15.15 (6.86–33.45)b |
| Mortality | 1.22 (0.28–5.22) | 0.18 (0.02–1.31) | 0.44 (0.06–3.24) | 1.66 (0.39–7.12) | 5.92 (0.79–44.67) |
| Total SMM events | 0.99 (0.90–1.08) | 1.06 (1.00–1.12) | 1.14 (1.05–1.24)b | 1.34 (1.21 –1.49)b | 1.99 (1.57–2.54)b |
The following SMM cases were not included in the table because there were too few cases for estimation: acute myocardial infarction, amniotic fluid embolism, aneurysm, cardiac arrest/ventricular fibrillation, conversion of cardiac rhythm, shock, sickle cell disease with crisis, temporary tracheostomy.
aOR, adjusted odds ratio; BMI, body mass index; CI, confidence interval; DIC, XXX; SMM, severe maternal morbidity.
a
Adjusted for maternal age, race and ethnicity, education level, insurance, neighborhood poverty level, parity, smoking, and prenatal care adequacy.
b
Indicates statistically significant results.