397 Can obesity explain racial disparities in severe maternal morbidity?

To test the role of prepregnancy obesity as a mediator in association between race and severe maternal morbidity (SMM). We conducted an analysis on population-based retrospective cohort study using 2010-2014 birth records linked with hospital discharge data New York City (n=591,455 live births). A multivariable logistic regression mediation model subgroup sample consisting normal weight obese women (n=409,021) decomposed total effect SMM into indirect obesity-mediated residual not mediated by obesity. sensitivity was excluding 11,973 cases due to blood transfusion. 15,158 were identified (256.3 per 10,000 deliveries). The rate among higher than that (342 versus 216 Black had nearly three times White (420 146 deliveries) Latinas twice (285 Among or BMI only (n=409,021), strongly associated (aOR 2.90, 95%CI 2.74-3.07) but obesity-mediated/indirect represented 3.2% 1.03, 1.02-1.05). Latina also 1.92, 1.80-2.05) similarly small: 3.4% 1.02, 1.01-1.03). transfusion found yet still limited (15.3%) (20.7%) race. Our findings indicate obesity, modifiable factor, is driver racial disparities SMM. Future investigations should focus roles other health conditions, medical providers, structural racism inequities.View Large Image Figure ViewerDownload Hi-res image Download (PPT)