LAUSR

with highest class III obesity prevalence, and bottom sextile (S6) had the three hospitals with the lowest prevalence. The prevalence of class III obesity was 9.1% in S1 and 1.3% in S6. Controlling for the baseline CD rate at each individual hospital, the odds of a woman with class III obesity experiencing a primary NTSV CD was approximately 1.5 fold higher among hospitals in S6 compared to those in S1 (OR 1.46, 95% CI 1.02 e 2.11, p1⁄40.04). CONCLUSION: Our data demonstrates that institutional level experience with class III obesity influences the primary NTSV CD rate in this high risk population. As we continue to optimize the primary CD rate, these results support the concept of regionalization of care for women with class III obesity. Further studies are needed to evaluate factors that could be contributing to this variance between hospital settings.