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174 How well does assessing hemorrhage risk on admission correspond with peripartum morbidity? Homa K. Ahmadzia, Richard L. Amdur, Jaclyn M. Phillips, Naomi L. Luban, Alexis C. Gimovsky The George Washington University School of Medicine and Health Sciences, Washington, DC, Children’s National Medical Center, Washington, DC OBJECTIVE: To evaluate the extent to which a novel assessment of hemorrhage risk on admission corresponds with morbidity in the peripartum period. STUDY DESIGN: This retrospective cohort analysis of a multicenter database included women admitted to labor and delivery from June 2016 to June 2018. A novel nursing assessment developed by Association of Women’s Health, Obstetric and Neonatal Nurses was used to categorize patients as low, medium or high risk for hemorrhage. Outcomes related to blood transfusion, estimated blood loss (EBL) 1000cc, ICU admission, general anesthesia and oxytocin use were evaluated based on hemorrhage risk score. RESULTS: Data were available for 56,671 births. There were 14,861 low risk (26%), 26,080 (46%) moderate risk, and 15,730 (28%) high risk. There were a total of 275 women (0.5%) who had blood transfusion and 3,717 women (6.6%) with EBL 1000cc. Tracking shell level (low/medium/high) designation is significantly associated with all the outcomes examined (Table). For women with high risk scores, the relative risk ratio compared with low risk womenwas 4.9 (95%CI 3.27.4) for blood transfusion and 5.2 (4.6-5.9) for EBL 1000cc. Only 9.5% of women (26/275) who were categorized as low risk for hemorrhage required a blood transfusion. For high versus low risk and the outcome of EBL 1000cc, the sensitivity was 85%, specificity was 51%, positive predictive value 10%, negative predictive value 98%.