666: Obesity as an independent risk factor for severe maternal morbidity (“near miss”) during delivery hospitalization

maternal morbidity (“near miss”) during delivery hospitalization Heather Lipkind, Katherine Campbell, David Savitz, Valery Danilack, Matthew Goldshore, Erika Werner Yale University, Obstetrics, Gynecology and Reproductive Science, New Haven, CT, Brown University, Public Health-Epidemiology, Providence, RI, The Johns Hopkins University School of Public Health, Population, Family and Reproductive Health, Baltimore, MD, The Johns Hopkins University School of Medicine, Gynecology and Obstetrics, Baltimore, MD OBJECTIVE: To examine the association between maternal obesity on “near miss” events during the delivery hospitalization. STUDY DESIGN: We used 1995-2003 NYC birth certificates linked to hospital discharge data to identify delivery hospitalizations with maternal diagnoses and procedures that indicated a possible life-threatening diagnosis or a life-saving procedure (near miss). We used indicators described in previous work by Callaghan et al (AJOG, 2008). Data were limited to singleton, live born neonates. Deliveries complicated by maternal death or where the pre-pregnancy weight was unknown were excluded. Women with a pre-pregnancy weight / 200 pounds were considered overweight/obese (obese) based on previous studies. Logistic regression was used to evaluate near miss events in obese women compared to non-obese women. RESULTS: For 1995-2003 there were 935,717 live singleton births in New York City in which pre-pregnancy weight was collected. 6.2% of these women had a pre-pregnancy weight / 200lbs and were classified as obese. Acute renal failure, eclampsia, hysterectomy, mechanical ventilation, pulmonary embolus and septicemia were independently associated with obesity (see table). Women who were obese had substantially higher adjusted odds of a near miss event (AOR 3.02; 95% CI 2.77-3.28) compared to non-obese women after adjusting for maternal socioeconomic and demographic characteristics. These odds was reduced but remained significantly elevated after controlling for maternal co-morbid medical conditions such as diabetes, hypertension, chronic cardiac disease and pulmonary disease (AOR 1.53; 95% CI: 1.40-1.68). CONCLUSION: This study shows that morbidity is increased in women with an elevated pre-pregnancy weight even after adjusting for comorbid conditions. It is important to understand contributors to lifethreatening maternal morbidity in order to improve obstetrical care. 667 Effect of feed restriction during gestation and lactation period on changes in hepatic lipid metabolism in 3-week-old male rat pups Hye Won Kim, Sangmi Lee, Mi Hye Park, Sun Hee Chun, Young Ju Kim School of Medicine, Ewha Womans University, Department of Obstetrics and Gynecology, Seoul, Republic of Korea, School of Medicine, Ewha Womans University, Department of Molecular Medicine, Seoul, Republic of Korea OBJECTIVE: We examined the effect of maternal feed restriction during gestation and lactation period on the hepatic lipid metabolism in 3-week-old male rat pups. STUDY DESIGN: Male and female Sprague-Dawley rats were mated after a one-week acclimation period with non-purified diet, and at day 10 of gestation, female rats were divided into two groups and given an ad libitum diet (AdLib) or 50% food restricted diet (FR). Pups were divided into three groups: 1) AdLib/AdLib, given AdLib throughout experimental period; 2) FR/AdLib, given FR during pregnancy and AdLib after delivery and 3) AdLib/FR, given AdLib during pregnancy and FR after delivery. On day 21 of lactation, male pups were killed by exsanguinations under anesthesia, and liver were removed immediately. The hepatic protein expression of sterol regulatory element binding protein 1 (SREBP1), fatty acid synthase (FAS) and acetyl-CoA carboxylase (ACC ) and (ACC ) were measured by western blot analysis. RESULTS: As compared to the AdLib/AdLib group, liver weight was decreased in the AdLib/FR group (P 0.05) whereas the FR/AdLib group was not differed. The SREBP1 expression was higher in the AdLib/FR group than in the AdLib/AdLib and FR/AdLib groups (P 0.01). The FAS expression was lower in the FR/AdLib and AdLib/FR groups than in the AdLib/AdLib group (P 0.0001). The ACC expression was higher in the FR/AdLib group than in the AdLib/AdLib group (P 0.05). No ACC was detected in any groups. CONCLUSION: Our results suggest that maternal feed restriction during prenatal and early postnatal period could influence on changes of lipid metabolism in the liver of 3-week-old male pups. Moreover, these changes may independently affect to liver by when feed restriction has been occurred.