
A retrospective cohort study of 223,837 singleton live births in Central New York (2010–2022) revealed a significant association between increased body mass index (BMI) and severe maternal morbidity (SMM). Each 1-point BMI rise raised SMM odds by 0.8% (aOR 1.008, 95% CI 1.002–1.013) and ICU admission by 2.0% (aOR 1.02, 95% CI 1.005–1.034). Patients with BMI 40–49.9 kg/m² had a 69% increased ICU admission risk (aOR 1.69, 95% CI 1.16–2.47), and those with BMI ≥50 kg/m² had triple the risk (aOR 3.01, 95% CI 1.53–5.91). However, BMI 30–39.9 kg/m² was not significantly associated with ICU admission. These findings highlight the need for targeted interventions in managing maternal health in patients with elevated BMI.
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