Abstract Body: Cardiovascular disease (CVD) is the most common cause of death in adults over 40 years of age. CVD remains a common cause of death in pregnancy and within the first-year post-partum, and Black women have higher cardiovascular risk during pregnancy than White women. There are several established mortality and morbidity prediction models for maternal cardiac complications including the Cardiac Disease in Pregnancy (CARPREG) risk score. CARPREG-II is the newest risk score which uses ten criteria to predict maternal cardiac complications. However, the only study to validate the CARPREG-II risk score had a large sample size with only 15% of patients with obesity (body mass index (BMI) >30 kg/m2). Obesity and increased obesity class are known risks factors for pregnancy related morbidity and mortality. Thus, the validity of CARPREG-II risk score as a predictor of cardiovascular risks and pregnancy outcomes in women with cardiac disease and obesity remains unknown. Therefore, the goals of our study were to assess the validity of the CARPREG-II score in Black and White women as a predictor of risk for cardiovascular morbidity and mortality in obese pregnant women and determine if obesity influences CARPREG-II score and pregnancy morbidity and mortality. For this study, we completed an IRB-approved retrospective chart review of 232 pregnant adult Black and White women who received care at the University of Mississippi Medical Center (UMMC) from January 2013 - 2020. We completed a CARPREG-II risk score and compared morbidity in patients with normal BMI (18-24.9 kg/m2), overweight (25-29.9 kg/m2), obesity class I (30-34.9 kg/m2), obesity class II (35-39.9 kg/m2), and obesity class III (>40 kg/m2). By race, the majority of White women were categorized as overweight; whereas the majority of Black women were categorized as obesity class II or III (p=0.0016). Although frequency of BMI category differed by race, CARPREG-II score did not differ as BMI increased in Black or White women, and obesity class did not influence CARPREG-II risk score. Our data indicate that Black women were more likely to have increased obesity, but obesity class did not influence CARPREG-II score. The lack of association between obesity class and CARPREG-II risk score indicate that the current CARPREG-II assessment is not an appropriate risk assessment tool for pregnant obese women and additional studies/tools are warranted to determine cardiovascular risks in pregnant obese women.