Sexual dimorphism in neonates and maternal stature at term pregnancy predispose delivery outcomes: Considering predilection of spontaneous vaginal delivery for healthy pregnancies in Nigeria

Abstract

Objectives: We aim to develop a labor protocol for male or female birth, base on maternal and neonatal stature. Materials and method: A prospective study of a cross section of pregnant mothers and their newborn babies, based on convenient sampling technique. A total of 480 mothers that were identified by a gynecologist as having healthy pregnancies and their newborn babies in gynecology ward of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria, from 1st July to 1st December, 2019, volunteered to participate in this study. Maternal and neonatal anthropometries; weight, height, BMI, waist girth (WG), hip girth (HG), birth head girth (BHG), and delivery outcomes: mode of delivery and duration of first and second stages of labor, and Apgar score at 1 minute of birth were considered. We adopted the guidelines of Institute of Medicine for direct anthropometric measurements.Results: The study recorded low prevalence of cesarean deliveries and abnormal apgar score. Male birth weight was dependent on maternal age, weight and HG (P<0.05). Birth weight and length, WG and HG could predict mode of delivery of male birth. Maternal and birth anthropometric features could not predict the duration of first stage of labor, but maternal age, BMI, HG and percentage body fat could determine that of second stage for female birth. Apgar score was dependent on birth weight and mode of delivery and duration of second stage of labor. Conclusions: The study reveals that maternal and male birth features tend to be similar, and relatively large maternal waist-hip ratio and fetal macrosomia at term pregnancy could be risk factors of male birth through vagina. Advance age of mothers in pregnancy and overweight and large WHR could be responsible for prolong labor, which leads to abnormal Apgar score. Relatively young expectant mothers with normal BMI and WHR could be granted more time during second stage of labor, since it could enhance the Apgar score of female birth. The study provided a comprehensible means to enable the gynecologists and midwives advice expectant mothers on possible risk of birth through vagina, with respect to her baby’s sex and her belief or cultural obligations.