Sub-Analysis of Obesity in Autopsy Series of Maternal Cardiopulmonary Deaths in Two Tertiary Centres in the United Kingdom
K Ohta-Ogo, SV Noronha, E Shamil, S Lucas, MN Sheppard. Royal Brompton and Harefield NHS Foundation Trust Hospital, London, United Kingdom; Imperial College London, London, United Kingdom; St Thomas' Hospital, London, United Kingdom
Background: Obesity in pregnancy has become a significant maternal risk. The aim of this study was to investigate obesity in maternal cardiopulmonary deaths in two tertiary centres in the UK.
Design: In our retrospective study of 81 maternal cardiopulmonary deaths collected from our combined archives of autopsies and consultation cases from 1994 to 2009, we analysed 47 cases (58%) where body mass index (BMI) data was available.
Results: In 47 cases of maternal deaths with known BMI, thirty (64%) were found to be obese (BMI ≥30) or overweight (BMI ≥25, <30). Obesity (n=20) including six morbidly obese (BMI ≥40) predominated over overweight cases (n=10). The proportion of obese/overweight (BMI ≥25) increased progressively by 17% in the period of 1998 to 2009. The predominant cardiac causes of death in the BMI ≥25 group were sudden cardiac death with morphological normal heart followed by cardiomyopathy mainly left ventricular hypertrophy (LVH) (Table 1). Simple regression analysis revealed the strong correlation between heart weight and BMI in subjects with normal heart and LVH (r = 0.81, P <0.001). Obesity was also linked to pulmonary embolic disease and pulmonary hypertension.
|BMI<25 (n=17)||BMI≥25 (n=30)||Total (n=47)|
|Sudden death with morphologically normal heart||3||7||10|
|Other cardiovascular disease||2||5||7|
|Pulmonary embolic disease (inc. AFE)||2||7||9|