The influence of obesity on incidence of complications in patients hospitalized with ovarian hyperstimulation syndrome

Objective To study the impact of body habitus on risk of complications resulting from ovarian hyperstimulation syndrome (OHSS) in hospitalized patients. Methods This is a retrospective observational study examining the National Inpatient Sample between January 2012 and September 2015. Patients were women < 50 years of age diagnosed with OHSS, classified as non-obese, class I–II obesity, or class III obesity. Intervention included multinomial logistic regression to identify factors associated with obesity and binary logistic regression for independent risk factors for complications. Main outcome measures were incidence of (i) any or (ii) multiple complication(s). Results Of 2745 women hospitalized with OHSS, 2440 (88.9%) were non-obese, 155 (5.6%) had class I–II obesity, and 150 (5.5%) had class III obesity. Obese women (either class I–II or III) had a higher degree of comorbidity, had lower incomes, and were less likely to have private insurance than non-obese women (all P < 0.001). Obese women had lower rates of OHSS-related complications than non-obese women (any complication: non-obese 65.2%, class I–II 54.8%, and class III 46.7%, P < 0.001; and multiple complications: non-obese 38.5%, class I–II 32.3%, and class III 20.0%, P < 0.001). In the multivariable model, obesity remained independently associated with a decreased risk of complications (class I–II odds ratio 0.57, 95% confidence interval 0.39–0.83, P = 0.003; class III odds ratio 0.30, 95% confidence interval 0.20–0.44, P < 0.001). Obese women were also less likely to require paracentesis (non-obese 32.8%, class I–II 9.7%, and class III 13.3%, P < 0.001). Conclusion Our study suggests that obesity is associated with decreased OHSS-related complication rates in hospitalized patients.