817: Indications for primary cesarean delivery and peripartum maternal and neonatal complications

816 Impact of obesity on cesarean Shayna Norman, Methodius Tuuli, Ryan Longman, Anthony Odibo, Alison Cahill Washington University in St. Louis, Obstetrics and Gynecology, St. Louis, MO OBJECTIVE: To evaluate the length of time from cesarean skin incision to infant delivery time and total operating time for women with increasing body mass index (BMI), and the possible effects of increased time from skin incision to delivery of the infant on neonatal acidosis. STUDY DESIGN: We performed a retrospective cohort study of all cesarean deliveries occurring at one institution from 2004-2008. Four comparison groups were defined by body mass index (BMI) 30 (n 768), 30-39.9 (n 1134), 40-49.9 (n 436), or 50 (n 205). Primary outcomes were time from skin incision to delivery and time from skin incision to skin closure. Secondary outcomes included umbilical arterial pH and base excess. RESULTS: Increasing BMI was associated with significantly increased time from skin incision to infant delivery and total operating time when compared to non-obese patients. Time from skin incision to delivery of the infant was 9.4 5.8 minutes for patients with BMI 30 vs. 15.9 11.2 minutes for patients with BMI 50, with a p-value 0.01. Neonatal umbilical arterial pH was lower and base excess was greater in obese patients undergoing cesarean. (Table) CONCLUSION: Increasing BMI is associated with a significantly increased time from skin incision to infant delivery, and the increased time may be associated with measures of neonatal acidosis. Cesarean technique remains to be optimized for obese women.