539 The effect of natural disasters on maternal morbidityAlissa Carver1, Marlo Cochran1, GayleOlson1, Mary Munn1, Gary Hankins2

1University of Texas Medical Branch, Ob/Gyn Maternal-FetalMedicine, Galveston, TX, 2The University of Texas MedicalBranch, Obsterics & Gynecology, Galveston, TXOBJECTIVE: Exposure to natural disasters may affect pregnancy out-comes. The objective of this study was to compare maternal morbidityin pregnancies prior to and following Hurricane Ike in September of2008.STUDY DESIGN: Retrospective case-control study examining triage vis-its to our institution over an 18-month period after Hurricane Ike(1/2009-6/2010) in comparison to pre-hurricane controls (3/2007-9/2008). 10/2008-12/2008 was excluded due to interruption of hospitalservices from storm damage. Antepartum complications were evalu-ated as follows: chronic hypertension (CHTN), pregnancy-inducedhypertension (PIH), diabetes (DM), vaginal bleeding (VB), pyelone-phritis, pancreatitis, cholecystitis, hyperemesis gravidarum/nauseaand vomiting (HEG/NV), oligohydramnios, preterm premature rup-ture of membranes (PPROM), threatened preterm labor (PTL), in-trauterine growth restriction (IUGR), decreased fetal movement (DecFM), and abnormal fetal testing. Comparison of demographic infor-mation, individual and composite maternal morbidity were calcu-lated using chi-squared and t-test analyses.RESULTS: Out of 21,202 triage visits, 11,280 (53%) occurred prior tothe storm and 9,922 (47%) after. Only 8 % of patients resided onGalveston Island while the remainder resided on the Texas mainlandwhere any impact from this natural disaster would be expected to beminimal. Composite maternal morbidity increased significantly fol-lowing Hurricane Ike (OR 1.53, 95% CI 1.44-1.63, p�0.0001). Whenexamined separately, this shift remained true for the following vari-ables: CHTN, DM, pyelonephritis, oligohydramnios, PPROM, DecFM, and abnormal fetal testing. Episodes of pancreatitis fell signifi-

cantly (Table 1). Despite a small proportion of patients originatingfrom Galveston proper, this effect was seen in our entire patient pop-ulation.CONCLUSION: Evidence suggests an overall increase in maternal com-plications based upon demand for care in a triage setting followingHurricane Ike. Clinicians should be prepared for increased morbidityand associated obstetric care requirements in pregnant women ex-posed to natural disasters.

540 Short interpregnancy intervals and maternalwell-being: the association with placental abruptionAllison Bryant1, Erin Madden2

1Massachusetts General Hospital, Vincent Obstetrics & Gynecology,Maternal Fetal Medicine, Boston, MA, 2Veteran’s HealthResearch Institute, NCIRE, San Francisco, CAOBJECTIVE: Short interpregnancy intervals (IPI) are associated withseveral adverse pregnancy outcomes such as preterm birth and fetaldeath. The risk of maternal complications is not clear. We sought todetermine whether short IPIs are associated with abnormal placenta-tion or bleeding complications of pregnancy.STUDY DESIGN: Data from vital statistics records for all births in Cali-fornia between 1999 and 2004 were linked with hospital dischargedata. For women with a first birth in 1999-2000 and a second birthbefore the end of 2004, multivariable modeling was used to determineassociations with placental abruption and placenta previa with IPI �6 months as the main risk factor of interest.RESULTS: 191,501 women met study inclusion criteria. Of these 1,538(0.8%) carried a diagnosis of placental abruption and 1,009 (0.5%)carried a diagnosis of placenta previa. After adjustment for potentialconfounders, IPI � 18 months. Adjustment for preexisting and preg-nancy-related hypertensive diagnoses did not change the point esti-mate for the effect of IPI on abruption risk. Placental abruption wasalso associated with having had no prenatal care during pregnancy,with operative delivery and with low birth weight and preterm birth.There was no association between IPI and placenta previa or antepar-tum hemorrhage.CONCLUSION: An interval of less than 6 months between a first andsecond pregnancy is associated with the diagnosis of placental abrup-tion in the second pregnancy, irrespective of hypertensive disorders.Placental dysfunction may be one mechanism by which a short IPIincreases the risk of preterm birth.

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