The Dual Burden of Malnutrition Increases the Risk of Cesarean Delivery: Evidence From India

Wells, Jonathan C. K.; Wibaek, Rasmus; Poullas, Marios S.

doi:10.3389/fpubh.2018.00292

Cited by 32 publications

(47 citation statements)

References 47 publications

(59 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several factors have been associated with high rates of CS. It has been showed that the dual burden of malnutrition -the coexistence of short stature and overweight/obesity-exacerbate obstetric complications through influences on maternal phenotype and new-born size (Wells, Wibaek, & Poullas, 2018). Almost 63% of mothers of this sample exhibited short stature and high BMI.…”

Section: Discussionmentioning

confidence: 88%

Caesarean birth and adiposity parameters in 6‐ to 8‐year‐old urban Maya children from two cities of Yucatan, Mexico

Azcorra

Rodríguez

Banik

et al. 2019

American J Hum Biol

View full text Add to dashboard Cite

Objectives: To analyze the association between birth mode and fat mass index (FMI= fat mass [kg]/height [m] 2 ), and z-score values of waist circumference (WCZ) and sum of triceps and subscapular skinfolds (SumSkfZ) in a sample of 256 6 to 8year-old urban Maya children from the cities of Merida and Motul in Yucatan, Mexico. waist circumference and skinfolds in children and height and weight in their mothers. Body composition was estimated in both generations through bioelectrical impedance analysis. Data on children's birth mode and birth weight were obtained from birth certificates. A pre-validated questionnaire for mothers was used regarding household living conditions. Multiple regression models were used to analyze the association between birth mode and adiposity parameters adjusting for the effect of place of residence, household crowding index, children's birth weight and maternal fat mass (FM). Separate regression models were run for boys and girls. Results: Caesarean-born children comprised 43% of the entire sample.Caesarean section (CS) was found to be associated with higher values of body adiposity in girls, but not in boys. Specifically, our models predicted that girls born by CS had an increased value of 0.817 kg/m 2 in FMI and showed higher standard deviations values for WCZ and SumskfZ (0.29 and 0.32 SD, respectively) than girls who were delivered vaginally. Discussion:Our results support the hypothesis that CS is associated with increased levels of adiposity in childhood, but only in girls.

show abstract

Section: Discussionmentioning

confidence: 88%

Caesarean birth and adiposity parameters in 6‐ to 8‐year‐old urban Maya children from two cities of Yucatan, Mexico

Azcorra

Rodríguez

Banik

et al. 2019

American J Hum Biol

View full text Add to dashboard Cite

show abstract

“…Overweight and obesity raise the risk of macrosomic offspring, increasing the risk of fetomaternal disproportion and obstructed labor. Indeed, a recent study found that Indian women who were both short and overweight were more likely to have a cesarean delivery than women who were either short or overweight alone (Wells, Wibaek, & Poullas, ).…”

Section: Discussionmentioning

confidence: 99%

“…Future work should seek to characterize the developmental trajectory of different pelvic dimensions and also investigate the potential impacts of early‐life nutritional interventions (eg, those aimed at reducing stunting) on adult pelvis size and shape. It will be important to focus efforts on reversing negative secular trends in height, especially in populations where maternal BMI is increasing (Wells et al, ). This can be achieved by improving success in the prevention of early linear growth faltering and stunting.…”

Section: Discussionmentioning

confidence: 99%

Developmental origins of variability in pelvic dimensions: Evidence from nulliparous South Asian women in the United Kingdom

Shirley

Cole

Arthurs

et al. 2019

American J Hum Biol

View full text Add to dashboard Cite

Objectives Pelvic growth may be sensitive to early‐life nutrition, with implications for maternal risk of obstructed labor. However, the “developmental origins” of adult pelvic variability require further investigation. We tested whether adult pelvic dimensions are associated with two components of height, indexing different periods of linear growth: tibia length, a proxy for early postnatal growth, and height‐residual (height regressed on tibia length), a proxy for later growth. We also tested whether adult pelvic dimensions are associated with birth weight, a marker of nutritional investment in utero. Methods In this cross‐sectional study, data were obtained on 68 nulliparous young women of South Asian ancestry. Pelvic dimensions (bi‐iliac and bi‐acetabular breadth, anteroposterior pelvic inlet and outlet, interspinous and intertuberous diameter) were measured using magnetic resonance imaging. Height and tibia length were measured manually. Birth weight and gestational age were obtained by recall. Multivariable regression models were fitted with a given pelvic dimension regressed on height‐residual, tibia, and birth weight, with the latter adjusted for gestational age. Results Controlling for birth weight, height‐residual was predictive of bi‐acetabular breadth, bi‐iliac breadth, and the pelvic inlet, while tibia length significantly predicted all dimensions except interspinous diameter. Controlling for the linear growth variables, birth weight was predictive of bi‐iliac breadth only. Conclusions Markers of linear growth during both early and later development were associated with adult pelvic dimensions, whereas size at birth was poorly predictive. Efforts to reduce stunting in early life may facilitate the attainment of maximum potential growth for both height and the pelvis.

show abstract

“…For obstetricians, our hypothesis may appear unintuitive because many previous studies documented that-at an individual level-taller women have lower, not higher, rates of obstructed labour [7,11,14,46]. However, we propose thatat a population level-the intergenerational change of body size, not only current body size, affects obstructed labour: the faster the environmentally induced increase in body size, the more frequent is fetopelvic disproportion.…”

Section: Introductionmentioning

confidence: 75%

Secular changes in body height predict global rates of caesarean section

Zaffarini

Mitterœcker

2019

Proc. R. Soc. B.

View full text Add to dashboard Cite

The massive global variation in caesarean-section (C-section) rate is usually attributed to socio-economic, medical and cultural heterogeneity. Here, we show that a third of the global variance in current national C-section rate can be explained by the trends of adult body height from the 1970s to the 1990s. In many countries, living conditions have continually improved during the last century, which has led to an increase in both fetal and adult average body size. As the fetus is one generation ahead of the mother, the fetus is likely to experience better environmental conditions during development than the mother did, causing a disproportionately large fetus and an increased risk of obstructed labour. A structural equation model revealed that socioeconomic development and access to healthcare affect C-section rate via multiple causal pathways, but the strongest direct effect on C-section rate was body height change. These results indicate that the historical trajectory of socio-economic development affects-via its influence on pre-and postnatal growth-the intergenerational relationship between maternal and fetal dimensions and thus the difficulty of labour. This sheds new light on historic and prehistoric transitions of childbirth and questions the World Health Organization (WHO) suggestion for a global 'ideal' C-section rate. BackgroundCompared with other mammals, childbirth in humans is strikingly difficult owing to the tight fit between the baby's head and shoulders and the mother's pelvis [1][2][3][4][5]. United States (US) statistics suggest that cephalopelvic disproportion-a mismatch of the fetal head and the maternal birth canal-occurs in 2.3% of infants weighing 3-4 kg at birth and in 5.8% of those weighing more [6]. A number of individual risk factors for cephalopelvic disproportion have been identified, including maternal and paternal body height, obesity and the age of the mother [7][8][9][10][11][12][13][14]. In most countries, however, the rate (i.e. incidence) of caesarean section (C-section) greatly exceeds that of actual anatomical disproportion [15][16][17]. Even if the birth canal can accommodate the fetus, a tight feto-pelvic fit can delay labour and increase the risk of maternal and fetal morbidity, which is often prevented by caesarean intervention. C-section rates have been reported to correlate also with psychological factors such as fear and anxiety, socio-economic factors such as family income and education, as well as with access to healthcare [18][19][20][21][22][23]. As a result, C-section rate varies considerably across social and demographic groups within most countries. At a global level, C-section rate varies even more starkly, ranging from 1-2% in many sub-Saharan African countries, up to about 50% in Egypt, Turkey or Brazil. Even in Europe, which is culturally and socio-economically relatively homogeneous, incidences range from about 15% in Scandinavia to more than 35% in Portugal, Romania and Italy [16,17]. Especially in developing countries, incidences are rising rapidly [16,...

show abstract

The Dual Burden of Malnutrition Increases the Risk of Cesarean Delivery: Evidence From India

Cited by 32 publications

References 47 publications

Caesarean birth and adiposity parameters in 6‐ to 8‐year‐old urban Maya children from two cities of Yucatan, Mexico

Caesarean birth and adiposity parameters in 6‐ to 8‐year‐old urban Maya children from two cities of Yucatan, Mexico

Developmental origins of variability in pelvic dimensions: Evidence from nulliparous South Asian women in the United Kingdom

Secular changes in body height predict global rates of caesarean section

Contact Info

Product

Resources

About