(997) Neonatal outcomes following betamethasone administration in patients with obesity

 Retrospective case-control study of preterm deliveries during which each patient obtained at least one dose of betamethasone. The control group included BMIs < 30 and the study group included BMIs ≥ 30. Exclusion included multiple gestations, T1DM, T2DM with pregnancy Hgb A1C > 7.0%, chorioamnionitis, non-reassuring fetal heart tones requiring emergent delivery, fetal aneuploidy or major structural anomalies, and neonatal abstinence syndrome. Multivariate logistic regressions were performed to compare individual and composite neonatal resuscitation and NICU outcomes by BMI status with adjustments made for gestational age at delivery, neonatal birth weight, diagnosis of preeclampsia, and delivery by cesarean section.

Results:

Of 1,240 total patients, 504 (40%) had BMIs < 30, 321 (26%) were class I obese, 200 (16%) were class II obese, and 217 (18%) were class III obese. Relative to the non-obese group, obese individuals were more likely to be older, of higher gravidity and parity, identify as Black American, deliver by cesarean, and experience preeclampsia. Neonates born to class III obese individuals experienced increased resuscitation with oxygen, PPV, and composite resuscitation (Table 1). No statistical differences in composite or individual neonatal outcomes (RDS, PVL, NEC, ROP, IVH), neonatal death, or length of NICU stay.

Conclusion:

The data demonstrated differences in the need for neonatal resuscitation in patients with class III obesity, despite adjustments for gestational age, neonatal birth weight, diagnosis of preeclampsia, and delivery by cesarean section. However, these interventions are short term, as longitudinal NICU stays or complications are not statistically different relative to non-obese individuals. This finding reveals a capacity for future investigations on potential divergent efficacies of pharmacotherapies in the class III obesity population compared to the non-obese population.