Effect of maternal height on the risk of caesarean section in singleton births: evidence from a large-scale survey in India

Marbaniang, Strong P.; Lhungdim, Hemkhothang; Chaurasia, Himanshu

doi:10.1136/bmjopen-2021-054285

Cited by 8 publications

(6 citation statements)

References 51 publications

(62 reference statements)

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“…Additionally, findings from a prospective cohort of Hispanic women in United States of America and from a population based study in Mexico are consistent with our results [ 38 , 39 ]. However, we did not observe higher odds of C-section in overweight or obese women of the short height group as discussed in other studies [ 19 , 20 ]. In contrast to these studies, short women in our population were not more likely to be overweight or obese compared to taller women [ 19 , 20 ].…”

Section: Discussioncontrasting

confidence: 59%

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

Sanchez-Samaniego,

Mäusezahl,

Hartinger-Peña

et al. 2024

BMC Pregnancy Childbirth

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Background During the last two decades, Caesarean section rates (C-sections), overweight and obesity rates increased in rural Peru. We examined the association between pre-pregnancy body mass index (BMI) and C-section in the province of San Marcos, Northern Andes-Peru. Methods This is a prospective cohort study. Participants were women receiving antenatal care in public health establishments from February 2020 to January 2022, who were recruited and interviewed during pregnancy or shortly after childbirth. They answered a questionnaire, underwent a physical examination and gave access to their antenatal care card information. BMI was calculated using maternal height, measured by the study team and self-reported pre-pregnancy weight measured at the first antenatal care visit. For 348/965 (36%) women, weight information was completed using self-reported data collected during the cohort baseline. Information about birth was obtained from the health centre’s pregnancy surveillance system. Regression models were used to assess associations between C-section and BMI. Covariates that changed BMI estimates by at least 5% were included in the multivariable model. Results This study found that 121/965 (12.5%) women gave birth by C-section. Out of 495 women with pre-pregnancy normal weight, 46 (9.3%) had C-sections. Among the 335 women with pre-pregnancy overweight, 53 (15.5%) underwent C-sections, while 23 (18.5%) of the 124 with pre-pregnancy obesity had C-sections. After adjusting for age, parity, altitude, food and participation in a cash transfer programme pre-pregnancy overweight and obesity increased the odds of C-section by more than 80% (aOR 1.82; 95% CI 1.16–2.87 and aOR 1.85; 95% CI 1.02–3.38) compared to women with a normal BMI. Conclusions High pre-pregnancy BMI is associated with an increased odds of having a C-section. Furthermore, our results suggest that high BMI is a major risk factor for C-section in this population. The effect of obesity on C-section was partially mediated by the development of preeclampsia, suggesting that C-sections are being performed due to medical reasons.

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Section: Discussioncontrasting

confidence: 59%

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

Sanchez-Samaniego,

Mäusezahl,

Hartinger-Peña

et al. 2024

BMC Pregnancy Childbirth

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“…It has already been reported that maternal stature is linked with adverse child and maternal health outcomes [44,60,61,[76][77][78][79]. Several studies have also examined the association of maternal height with child malnutrition [40,42,43,80].…”

Section: Discussionmentioning

confidence: 99%

Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey

Sahiledengle

Mwanri

Agho

2023

J Health Popul Nutr

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Background Undernutrition among under-five children is one of the intractable public health problems in Ethiopia. More recently, Ethiopia faced a rising problem of the double burden of malnutrition—where a mother may be overweight/obese, and a child is stated as having undernutrition (i.e., stunting, wasting, or underweight) under the same roof. The burden of double burden of malnutrition (DBM) and its association with maternal height are not yet fully understood in low-income countries including Ethiopia. The current analysis sought: (a) to determine the prevalence of double burden of malnutrition (i.e., overweight/obese mother paired with her child having one form of undernutrition) and (b) to examine the associations between the double burden of malnutrition and maternal height among mother–child pairs in Ethiopia. Methods We used population-representative cross-sectional pooled data from four rounds of the Ethiopia Demographic and Health Survey (EDHS), conducted between 2000 and 2016. In our analysis, we included children aged 0–59 months born to mothers aged 15–49 years. A total of 33,454 mother–child pairs from four waves of EDHS were included in this study. The burden of DBM was the primary outcome, while the maternal stature was the exposure of interest. Anthropometric data were collected from children and their mothers. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. The association between the double burden of malnutrition and maternal stature was examined using hierarchical multilevel modeling. Results Overall, the prevalence of the double burden of malnutrition was 1.52% (95% CI 1.39–1.65). The prevalence of overweight/obese mothers and stunted children was 1.31% (95% CI 1.19–1.44), for overweight/obese mothers and wasted children, it was 0.23% (95% CI 0.18–0.28), and for overweight/obese mothers and underweight children, it was 0.58% (95% CI 0.51–0.66). Children whose mothers had tall stature (height ≥ 155.0 cm) were more likely to be in the double burden of malnutrition dyads than children whose mothers’ height ranged from 145 to 155 cm (AOR: 1.37, 95% CI 1.04–1.80). Similarly, the odds of the double burden of malnutrition was 2.98 times higher for children whose mothers had short stature (height < 145.0 cm) (AOR: 2.98, 95% CI 1.52–5.86) compared to those whose mothers had tall stature. Conclusions The overall prevalence of double burden of malnutrition among mother–child pairs in Ethiopia was less than 2%. Mothers with short stature were more likely to suffer from the double burden of malnutrition. As a result, nutrition interventions targeting households’ level double burden of malnutrition should focus on mothers with short stature to address the nutritional problem of mother and their children, which also has long-term and intergenerational benefits.

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“…Consistent with previous studies, 19,20 we found that the size of the pelvic inlet was positively correlated with body height, implying that shorter women, on average, had a smaller inlet and an increased probability of giving birth by cesarean section. Several previous studies have shown a correlation between body height and the probability of delivery by cesarean section 21,22 . However, group differences in inlet size persisted after controlling for body height, implying that inlet area cannot be reliably predicted for individual cases by measuring maternal body height.…”

Section: Discussionmentioning

confidence: 89%

“…Several previous studies have shown a correlation between body height and the probability of delivery by cesarean section. 21 , 22 However, group differences in inlet size persisted after controlling for body height, implying that inlet area cannot be reliably predicted for individual cases by measuring maternal body height.…”

Section: Discussionmentioning

confidence: 99%

Pelvic inlet area is associated with birth mode

Starrach

Schmidhuber

Elger

et al. 2022

Acta Obstet Gynecol Scand

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Introduction To determine whether a pelvis is wide enough for spontaneous delivery has long been the subject of obstetric research. A number of variables have been proposed as predictors, all with limited accuracy. In this study, we use a novel three‐dimensional (3D) method to measure the female pelvis and assess which pelvic features influence birth mode. We compare the 3D pelvic morphology of women who delivered vaginally, women who had cesarean sections, and nulliparous women. The aim of this study is to identify differences in pelvic morphology between these groups. Material and methods This observational study included women aged 50 years and older who underwent a CT scan of the pelvis for any medical indication. We recorded biometric data including height, weight, and age, and obtained the obstetric history. The bony pelvis was extracted from the CT scans and reconstructed in three dimensions. By placing 274 landmarks on each surface model, the pelvises were measured in detail. The pelvic inlet was measured using 32 landmarks. The trial was registered at the German Clinical Trials Register DRKS (DRKS00017690). Results For this study, 206 women were screened. Exclusion criteria were foreign material in the bony pelvis, unknown birth mode, and exclusively preterm births. Women who had both a vaginal birth and a cesarean section were excluded from the group comparison. We compared the pelvises of 177 women between three groups divided by obstetric history: vaginal births only (n = 118), cesarean sections only (n = 21), and nulliparous women (n = 38). The inlet area was significantly smaller in the cesarean section group (mean = 126.3 cm2) compared with the vaginal birth group (mean = 134.9 cm2, p = 0.002). The nulliparous women were used as a control group: there was no statistically significant difference in pelvic inlet area between the nulliparous and vaginal birth groups. Conclusions By placing 274 landmarks on a pelvis reconstructed in 3D, a very precise measurement of the morphology of the pelvis is possible. We identified a significant difference in pelvic inlet area between women with vaginal delivery and those with cesarean section. A unique feature of this study is the method of measurement of the bony pelvis that goes beyond linear distance measurements as used in previous pelvimetric studies.

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Effect of maternal height on the risk of caesarean section in singleton births: evidence from a large-scale survey in India

Cited by 8 publications

References 51 publications

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey

Pelvic inlet area is associated with birth mode

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