Maternal height and newborn size relative to risk of intrapartum caesarean delivery and perinatal distress

Abstract

Objective To estimate the changes in risk of intrapartum caesarean delivery and perinatal distress that may be introduced through increased birth size, resulting from interventions such as improving nutrition of the mother; and to characterise delivery risk relative to maternal stature by birth size. Design Model these risks using data from the Guatemalan Perinatal Study. Setting The antenatal clinic of the Gynaecology and Obstetrics Hospital of the Guatemalan Social Security Institute in Guatemala City serving predominantly working class women. Population Women who had their first prenatal visit between April 1984 and January 1986. Methods Multivariate logistic regression models were developed to estimate incidence of intrapartum caesarean delivery and perinatal distress and used to calculate changes in risk associated with changes in size. Main outcome measures Incidences of intrapartum caesarean delivery and perinatal distress. Results A woman of 146cm height (‐1 SD) relative to another of 160cm (+1 SD) has a 2.5 times higher risk of intrapartum caesarean delivery. An increase in newborn head circumference and weight (from ‐1 SD to +1 SD) are each independently associated with an increase in risk of intrapartum caesarean delivery (2.0 times and 1.5 times, respectively). An increase in birthweight from 2,450 g to 2,550 g is associated with a decrease in risk of perinatal distress of 34/1000 cases and an increase in risk of intrapartum caesarean delivery of 8/1000 cases. Conclusions Increases in fetal growth comparable to those attributable to improved nutrition during pregnancy are associated with a larger decrease in risk of perinatal distress relative to the increase in risk of intrapartum caesarean delivery for the mother. Greater maternal stature is associated with lower risk of intrapartum caesarean delivery.

Inadequate intakes of dietary zinc among pregnant women from subsistence households in Sidama, Southern Ethiopia

“…Moreover, anecdotal reports indicate that pregnant women in Ethiopia may restrict their energy intake during late pregnancy in an effort to reduce risk of complications during delivery. Certainly, because of their short stature (mean HAZ 5 21.48) (Table 1), these women were likely to be at increased risk during delivery as a result of cephalo-pelvic disproportions 47 . Height below 148 cm has also been associated with poor foetal outcomes, and in this study 11.1% of the women had a height below 148 cm 48 .…”

Fatores de risco maternos associados à acidose fetal

“…5,[13][14][15] Entretanto, é importante enfatizar que a condição citada tem incidência baixa nos vários relatos da literatura. 16,17 Outra variável de desfecho pesquisada foi a alteração neurológica no RN no momento da alta, sendo incluída nesta variável qualquer alteração identificada no exame neurológico, tomografia de crânio ou ultrassonografia transfontanelar. O GAcid apresentou 17% de RN com alterações neurológicas e o GContr, 1,4%.…”

“…Entretanto, mulheres com altura inferior a 150 cm, quando comparadas as de altura superior a esse parâmetro, apresentaram 2,5 vezes mais risco de parto cesáreo por alteração da vitalidade fetal intraparto, com a consequente acidose fetal, conforme relatam Merchant et al 17 Assim, o pH/AU representa o mais sensível dos marcadores de hipoxemia fetal intraparto. A AFP consequente ao sofrimento fetal, indicou com maior frequência o nascimento de RN por cesariana.…”

A clinical study of association of maternal height and estimated foetal weight on mode of delivery

“…Thus women who are less than or equal to 145 cm have higher risk of emergency caesarean delivery when compared to women of more than 145 cm. In a study by Kathleen et al, 14 women of 146 cm height (-1 SD) relative to another of 160 cm (+1 SD) had a 2.5 times of higher risk of emergency caesarean delivery. The independent risk for emergency caesarean delivery occurring for a healthy, nulliparous women with no obstetric or clinical pathology but of 146 cm (-1 SD) was 2.5 times higher relative to women of 166 (+1 SD) in height was clearly established in their study.…”