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Obesity in Surgical Abortion: A Risk Factor for Complications? [13N]

INTRODUCTION: More than one-third of reproductive-aged women in the U.S. are obese. Obesity is a known risk factor for obstetric and surgical complications, but its association with abortion-related complications is not clear. Our objective was to evaluate obesity as an independent risk factor for complications of surgical abortion. METHODS: We performed a retrospective chart review of women who underwent surgical abortion in the first or second trimester in the outpatient setting between September 2012 and June 2014. Primary outcome was a composite of complications: estimated blood loss greater than or equal to 200 mL, uterine reaspiration, cervical laceration, uterine perforation, infection, emergency department visit, and hospitalization. Multivariable analysis was performed with log-binomial regression to calculate relative risk of complications based on BMI and adjusted for age, gestational age, history of prior cesarean section, and other comorbidities. RESULTS: We included 4977 women in our analysis. The majority (77%) were performed in the first trimester. Forty-seven percent were normal weight or underweight, 28% were overweight, and 25% of patients were obese, including 4% with BMI greater than 40. Complications occurred in 1.4% of procedures. There was no association between BMI and abortion complications (P=.60). CONCLUSION: In a high-volume outpatient abortion clinic with experienced providers, abortion is very safe. Obesity does not appear to be an independent predictor for abortion complications, and should not be used in isolation to refer women to hospital-based facilities.