Abstract
Objective We aim to quantify the impact of obesity on maternal intensive care unit (ICU) admission.
Materials and Methods This is a population-based, retrospective cohort study of Ohio live births from 2006
to 2012. The primary outcome was maternal ICU admission. The primary exposure was
maternal body mass index (BMI). Relative risk (RR) of ICU admission was calculated
by BMI category. Multivariate logistic regression quantified the risk of obesity on
ICU admission after adjustment for coexisting factors.
Results This study includes 999,437 births, with peripartum maternal ICU admission rate of
1.10 per 1,000. ICU admission rate for BMI 30 to 39.9 kg/m2 was 1.24 per 1,000, RR: 1.20 (95% confidence interval [CI]: 1.07, 1.35); BMI 40 to
49.9 kg/m2 had ICU admission rate of 1.80 per 1,000, RR: 1.73 (95% CI: 1.38, 2.17); and BMI ≥ 50
kg/m2 had ICU admission rate of 2.98 per 1,000, RR: 1.73 (95% CI: 1.77, 4.68). After adjustment,
these increases persisted in women with BMI 40 to 49.9 kg/m2 with adjusted relative risk (adjRR) of 1.37 (95% CI: 1.05, 1.78) and in women with
BMI ≥ 50 kg/m2, adjRR: 1.69 (95% CI: 1.01, 2.83).
Conclusion Obesity is a risk factor for maternal ICU admission. Risk increases with BMI. After
adjustment, BMI ≥ 40 kg/m2 is an independent risk factor for ICU admission.
Keywords
ICU admission - maternal obesity - severe maternal morbidity