Maternal Height, Pelvic Typology, and Mode of Delivery: A Cross-Sectional Study from South Punjab

Objective: To explore the relationship between maternal height and type of bony pelvis among reproductive age womenfrom South Punjab.Methodology: This cross-sectional study was conducted at Sheikh Zayed Hospital, Rahim Yar Khan, from May 2024 toOctober 2024. 384 postpartum females aged 18-35 years were included in this study. Maternal height was recorded bya stadiometer and pelvic type was measured through X Ray pelvimetry. Data were analyzed using Pearson correlationand Chi-square test.Results: The mean age was 26.7+4.5 (range 18- 35 years), mean height was 150.2+3.1 cm (range 145-155). The mostcommon type of pelvis was found to be gynecoid (38.0 %), followed by android (25.0%), anthropoid (22.0%) andplatypelloid (15.0%). Taller women were more likely to have gynecoid pelvis (r=0.35, p<0.01), while females categorizedas short heighted demonstrated higher frequency of android pelvis (r = -0.28, p < 0.05).Conclusion: Maternal height shows a positive correlation with pelvic type. Tall heighted females are more likely to havegynecoid pelvis which is suitable for vaginal delivery. The maternal height measurement may help in Obstetric planning.Key words: Maternal height, Pelvimetry, Bony pelvis, Obstetrics, Pelvic morphology

The primary aim of this study was to examine the association between maternal height and mode of delivery in nulliparous Japanese women. The secondary aim was to examine the association between maternal height and maternal and neonatal morbidities. This retrospective cohort study included women who gave birth at Osaka Women's and Children's Hospital, a tertiary perinatal center in Japan, from January 2015 to December 2017. Nulliparous Japanese women with singleton gestation, who went into labor at term were included in the study. The primary outcome was mode of delivery, and the secondary outcomes were maternal and neonatal morbidities. The relationships between maternal height and the outcomes were evaluated using multivariate logistic regression analysis adjusted for potential confounders. Maternal height was categorized into five groups with 5-cm increments for the analysis. A total of 1593 women were analyzed in this study. Shorter women had higher rate of cesarean delivery (CD) than taller women. There were no significant differences in the rates of operative vaginal delivery, maternal morbidity and neonatal morbidity among the maternal-height groups. The adjusted odds ratios (95% confidential interval) of maternal heights of <150 cm, 150-154 cm, 160-164 cm and ≥165 cm for CD, compared with a maternal height of 155-159 cm, were 3.56 (1.79-7.09), 1.68 (1.06-2.64), 0.63 (0.40-1.00) and 0.57 (0.30-1.01), respectively. Shorter nulliparous Japanese women were more likely to undergo intrapartum CD. However, the rates of maternal and neonatal morbidities in shorter women were similar to those in taller women.

IntroductionFetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers.MethodsThis was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12.ResultsIt was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01).ConclusionThe significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings.

Study Objectives: The aim of this study was to find if there is an association between maternal height and mode of delivery, as well as an association between maternal height and baby’s weight as a secondary outcome.Method: This retrospective record review was performed at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, including patients admitted between January 2016 to December 2017. All nulligravida with singleton term pregnancies who gave birth were included in this study. Pregnant women with planned elective cesarean section (CS) and incomplete records were excluded. The maternal demographic and clinical data (age, height, weight, hypertension, gestational diabetes (GDM), body mass index (BMI), smoking status, gestational age, regional analgesia during delivery, type of delivery, postpartum hemorrhage (PPH), and episiotomy), neonatal birth weight, and Apgar score were obtained from KAUH computerized records. Our primary outcome was the mode of delivery. The secondary outcome was the classification of neonatal weight into small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age (LGA). Maternal height was divided into seven groups. Descriptive statistics using mean and standard deviation were used for continuous variables. Frequencies and percentages were used for categorical variables. Student's t-test and chi-square tests were used to evaluate the differences between continuous and categorical variables.Result: A total of 1067 women were included in this study. Most were at 40 weeks of gestation age (14.9%) with a mean height of 156.4±6.2 cm. Of the total, 76.9% were spontaneous vaginal delivery without operative assistance, 15.9% were delivered via CS, and 7.2% delivered vaginally with the assistance of forceps or ventouse. The mean neonatal birth weight was 2994 ± 451 gms with most neonates (87.3%) having a birth weight between 2500 and 4000 gms. Most babies were of average weight for their gestational age at delivery. There was a significant negative association between maternal height with CS (p=0.017). Moreover, there was a correlation between maternal height and the baby’s birth weight (p=0.01), and we found that for every 1 cm increase in women’s height, the baby's weight increases by 12.8 gms.Conclusion: Our study didn’t find an association between maternal height and vaginal delivery or operative vaginal delivery. However, there was an impact of maternal height on CS delivery. Therefore, we suggest screening for short maternal height as they have an increased risk of having an emergency CS. In our secondary outcome, we found a positive association between maternal height and baby's birth weight.

BackgroundBirth related newborn and maternal mortality/morbidity remains high in most of sub-Saharan Africa compared to the rest of the world. In this low income region there is a need for valid, low cost, easy to use mass screening tests. This study looked at the screening value of maternal: height, weight and pelvis height, for assessing the outcomes of parturition in Ugandan mothers at term.MethodsThis was a multi site cross-sectional study on mothers with singleton pregnancies in labour at various hospitals in different parts of Uganda. A summary of the details of the pregnancy, maternal height, weight and the delivery record were captured and analysed to generate descriptive and inferential (multilevel logistic regression analysis) and diagnostic (Receiver Operator Curve analysis) statistics.ResultsWe recruited 1146 mothers from all the study sites during the study period of whom 987 (86.13%) had normal deliveries and healthy babies. Mothers with adverse outcomes included 107 mothers that had caesarean section and 52 mothers who had vaginal deliveries with foetal Apgar score of ≤7 at 5 min of whom 11 had fresh still births. Maternal height (Adj OR 0.97, 95% CI 0.94–1.00) and maternal pelvis height (Adj OR 0.73, 95% CI 0.61–0.86) were significantly associated with adverse pregnancy outcomes. The combination of maternal: height (<150 cm), weight (>55.7 kg) and pelvis height (>8.95 cm) had the best diagnostic value with a combined area under the curve of 0.60.ConclusionsIt was observed that an increase in either maternal pelvis height or maternal height was associated with a significant reduction in adverse pregnancy outcomes. The cut off values of all three evaluated maternal anthropometric measurements were of low test accuracy as screening tests even when used together. Further research is needed to develop low cost screening tools for use in low income settings.

X-ray pelvimetry is used for evaluation of pelvic inlet generally to diagnose cephalopelvic disproportion (CPD) or contracted inlet. Cesarean section delivery (C/S) is often performed for labor dystocia without CPD or contracted inlet. We examined whether X-ray pelvimetry is useful to decide on mode of delivery in women with dystocia. A total of 1118 pregnant women received X-ray pelvimetry before or during labor. 205 women with cesarean deliveries for indications except for dystocia were excluded. 913 women undergoing induction/augmentation were retrospectively investigated. Obstetrical and maternal variables were analyzed by univariate, multivariate or ROC analysis. Among 913 women, 37 including three with contracted inlet and seven with CPD, gave birth by C/S, whereas 876 gave birth by vaginal delivery. Low maternal height, older age, small obstetrical conjugate, large weight and infant head size were associated with risk of C/S for dystocia. Multivariate analysis revealed that the obstetrical conjugate was an independent variable for risk of C/S. The area under the ROC curve and the optimal cut-off values, respectively, were as follows: obstetrical conjugate: 0.68 and 11.7 cm (odds ratio = 4.27), transverse diameter: 0.59 and 11.4 cm (odds ratio = 1.82), maternal height: 0.70 and 155.5 cm (odds ratio = 4.33), and maternal weight before pregnancy: 0.55 and 49.7 kg (odds ratio = 1.98). The obstetrical conjugate was an independent variable associated with risk of C/S for dystocia. Maternal height was comparable to the conjugate in term of diagnostic ability. Our data suggested that routine X-ray pelvimetry was not beneficial to identify women at risk of C/S for dystocia.

IntroductionMaternal height has been shown to be associated with adverse outcomes in women with gestational diabetes mellitus (GDM). The aim of this study is to evaluate the association between maternal height and adverse outcomes stratified for gestational weight gain (GWG) and pre-pregnancy body mass index (BMI) in women with GDM.MethodsWe conducted a retrospective study that included 2048 women diagnosed with GDM during 24–28 gestational weeks from July 1, 2017, to June 30, 2018, in Zhejiang Province, China. Demographic data, maternal characteristics and pregnancy complications were extracted from medical records. Maternal height was divided into three categories by tertiles. Chi-square was used to evaluate categorical data while one-way ANOVA was utilized to analyze continuous variables. The relationship between maternal height and adverse outcomes was examined using logistic regression.ResultsWe found that shorter women had higher rates of low birth weight (LBW) (p = 0.003) and primary cesarean section (primary CS) (p < 0.001) while taller women had higher rates of abnormal neonatal ponderal index (p < 0.001), postpartum hemorrhage (p = 0.044) and macrosomia (p < 0.001). In taller women who had excess GWG, maternal height was positively associated with the risk of macrosomia (aOR 1.97, 95% CI 0.95–4.10). In shorter women who had inadequate GWG, maternal height was significantly associated with LBW (aOR 2.20, 95% CI 1.13–4.29) and primary CS (aOR 2.08, 95% CI 1.38–3.12). Maternal height was a protective factor of postpartum hemorrhage (aOR 0.15, 95% CI 0.03–0.72) in shorter women with excess GWG. In women with normal pre-pregnancy BMI, maternal height was positively associated with LBW (aOR 2.00, 95% CI 1.15–3.49) and primary CS (aOR 1.71, 95% CI 1.28–2.28) in shorter women while it was negatively associated with the risk of abnormal neonatal ponderal index in both shorter and taller women compared to average height women (aOR 0.71, 95% CI 0.55–0.92; aOR 0.66, 95% CI 0.51–0.85).ConclusionThe association between maternal height and adverse pregnancy outcomes varies with pre-pregnancy BMI and GWG in GDM women. Taking maternal height, pre-pregnancy BMI and GWG into account and using personalized prenatal management may reduce the risk of adverse pregnancy outcomes in GDM.

In low resource settings, maternal anthropometry may complicate time based monitoring of childbirth. We set out to determine the effect of maternal anthropometry and foetal birth weight on the duration of childbirth. Birth related secondary data from 987 mothers with pregnancies of ≥ 37 weeks, singleton baby and a normal childbirth were obtained. This data was analysed for regression coefficients and Interclass correlations coefficients (ICCs). The mean duration of childbirth was 7.63hours. Each centimetre increase in maternal pelvis height led to a 0.56hours increase for the first stage (P&lt;0.01), 0.05hours reduction for second stage (P&lt;0.01), and 0.46hours increase in total duration of childbirth (p&lt;0.01). For each centimeter increase in maternal height there was a 0.04hours reduction in the first stage (P=0.01) and a 0.005hours increase in second stage (P=0.03). The ICCs with respect to geographical site were 0.40 for stage 1, 0.27 for stage 2 and 0.21 for stage 3. Additional modeling with tribe of mother did not change the ICCs. Maternal pelvis height and maternal height were found to have a significant effect on the duration of the different stages of normal childbirth. Additional study is needed into the public health value of the above measurements in relation to childbirth in these settings.Key words: Humans; anthropometry; childbirth; pelvis height;

Small for gestational age (SGA) and large for gestational age (LGA) are designations given to neonates based solely on birthweight, with no distinction made for maternal height. However, there is a possibility that maternal height is significantly correlated with neonatal birthweight, and if so, SGA and LGA cutoffs specific to maternal height may be a more precise and useful tool for clinicians. To explore this possibility, we analyzed the association between maternal height and ethnicity and neonate birthweight in women with low-risk, 37- to 40-week gestation, singleton pregnancies who gave birth vaginally between 2010 and 2017 (n = 354,488). For this retrospective cohort study, we used electronic obstetric records obtained from the National Obstetrics Registry in Malaysia. National Obstetric Registry (NOR) data were used to calculate the 10th and 90th birthweight percentiles for each maternal height group by gestational age and neonatal sex. Multiple linear regression models, adjusted for maternal age, weight, parity, gestational age, and neonatal sex, were used to examine the association between neonate birthweight and maternal ethnicity and height. The following main outcome measures were assessed: small for gestational age (<10th percentile), large for gestational age (>90th percentile), and birthweight. The median height was 155 cm (IQR, 152-159), with mothers of Chinese descent being the tallest (median (IQR): 158 cm (154-162)) and mothers of Orang Asli (Indigenous) descent the shortest (median (IQR): 151 cm (147-155)). The median birthweight was 3000 g (IQR, 2740-3250), with mothers of Malay and Chinese ethnicity and Others having, on average, the heaviest babies, followed by other Bumiputeras (indigenous) mothers, mothers of Indian ethnicity, and lastly, mothers of Orang Asli ethnicity. For infants, maternal age, height, weight, parity, male sex, and gestational age were positively associated with birthweight. Maternal height had a positive association with neonate birthweight (B = 7.08, 95% CI: 6.85-7.31). For ethnicity, compared with neonates of Malay ethnicity, neonates of Chinese, Indian, Orang Asli, and other Bumiputera ethnicities had lower birthweights. Birthweight increases with maternal height among Malaysians of all ethnicities. SGA and LGA cutoffs specific to maternal height may be useful to guide pregnancy management.

To analyze the association between newborn and maternal characteristics and the risk for cesarean section (CS) due to cephalopelvic disproportion (CPD) and non-CPD causes compared to vaginal deliveries (VD) in a sample of infants and mothers from Merida, Yucatan, Mexico. The final sample consisted of 3453 single, live, and term infants born between January 2016 and May 2017 at the Maternal-Infant Hospital in Merida and their mothers (aged ≥19 years). The mode of delivery was established as the dependent variables: (a) VD, (b) CS due to CPD, and (c) non-CPD CS. Independent variables were maternal height and weight, the number of previous VD, newborn weight, and neonatal birthweight (BW) index/maternal height index. A multinomial regression model was used to analyze the association between newborn and maternal characteristics and outcome variable. By mode of delivery, 2124 (62%) births corresponded to VD, 1042 (30%) to non-CPDCS, and 287 (8%) to CS due to CPD. Mothers who had CS due to CPD weighed more at the end of their pregnancy and were shorter. Maternal age and weight increased the risk for having CS due to CPD compared to VD and maternal height, and the number of previous VD reduces the risk for experiencing CS due to CPD compared to vaginal births. The relative risk ratio for higher neonatal BW/maternal height index was significant for CS due to CPD and non-CPD CS. According to our results from a public hospital in Merida, Mexico, CPD is a result of the interrelation of maternal and fetal size, rather than an independent result of maternal height or BW.

Objective: To identify independent predictors of successful labor induction with oral or vaginal misoprostol.Methods: Women enrolled in four previous randomized trials involving oral or vaginal misoprostol for cervical ripening and labor induction were included in the present cohort study, with dosing of 25–50 μg every 4 to 6 h vaginally (n = 574) or 50 μg every 4 h orally (n = 207). Multiple logistic regression was performed to identify factors independently associated with successful labor induction – defined as vaginal delivery within 12 h, vaginal delivery within 24 h and spontaneous vaginal delivery. Predictors of Cesarean birth and the need for only one dose of misoprostol were also identified. Variables included in the models were maternal age, weight, height, parity, gravidity, membrane status, route of misoprostol, gestational age, birth weight, and Bishop score and its individual components.Results: Maternal age, height, weight, parity, birth weight, dilatation, effacement and cervical station were associated with vaginal delivery within 24 h of induction. Maternal age, height, weight, nulliparity, birth weight and route of misoprostol were associated with Cesarean birth, with oral misoprostol being associated with a lower rate of Cesarean birth. The need for only one dose of misoprostol was predicted by maternal height, weight, parity, gestational age, Bishop score and route of misoprostol.Conclusion: Characteristics of the woman (height, weight, parity), the fetus (birth weight) and some of the individual components of the Bishop score, were associated with successful labor induction, with oral misoprostol being associated with a lower rate of Cesarean birth.

Currently there are no existing data regarding the maternal and neonatal outcomes for nulliparous women delivering neonates with birthweight above 4500g. We aim to evaluate birth outcome among these subset of parturients. A retrospective study of nulliparous delivering a singleton fetus weighing ≥ 4500g in two tertiary medical centers between 2007 and 2018. Women who chose to undergo a trial of labor (TOL) were compared to those who underwent elective cesarean delivery (CD). Overall, 121 women were included. Seventy eight (65.4%) women elected a TOL while 43 (34.6%) had elective CD. Of women who chose TOL, 46 (59%) delivered with unassisted vaginal delivery, 28 (36%) by intrapartum CD, and 4 (5%) by assisted vaginal delivery, reaching TOL success rate of 64% (50/78). The rates of shoulder dystocia and anal sphincter injury in vaginal deliveries were 5/50 (10%) and 2/50 (4%) respectively. Successful TOL was negatively associated with the presence of gestational diabetes [5 (18%) vs. 0 (0%), OR 0.8 (95% CI 0.7-0.9), p = 0.005], and was positively associated with maternal height (median 170cm vs. 165cm, p = 0.002), epidural analgesia [42 (84%) vs. 16 (57%), OR 3.5 (95% CI 1.2-9.8), p = 0.009] and spontaneous onset of labor (38 (76%) vs. 10 (36%), OR 5.7 (95% CI 2.1-15.6), p = 0.001. Neonates born after TOL were more commonly complicated by meconium aspiration syndrome as compared to no TOL (9 (11%) vs. 0 (0%), OR 1.1 (95% CI 1.04-1.22, p = 0.02). Only maternal height was independently associated with successful TOL (aOR 6.9 (95% CI 1.03-46.3, p = 0.04). Maternal and neonatal adverse composite outcomes were associated with gestational hypertensive disorders (10 (50%) vs. 5 (5%). OR 19.2 (5.5-67.4), p < 0.001) and with delivery before 40weeks (9 (57%) vs, 86 (82%), OR 3.5 (95% CI 1.2-10.6, p = 0.02), respectively. Trial of vaginal delivery in nulliparous with fetuses ≥ 4500g was associated with a high failure rate, with only two thirds of parturients achieving successful vaginal delivery. Nevertheless, neonatal outcomes mostly did not differ according to the mode of delivery. Maternal height was the only factor associated with successful vaginal delivery.

Background: Height is easy to measure and may serve as a triaging and referral tool in the rural communities of the West African subregion where a significant proportion of deliveries are undertaken by unskilled birth attendants with devastating maternal and perinatal outcomes. Objective: The objective of this study was to determine the association between maternal height and the route of delivery. Materials and Methods: This was a cross-sectional study undertaken at the Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. A total of 180 consenting randomly selected pregnant participants who met the inclusion criteria and had presented in spontaneous labor at the maternity unit were selected for the study. Each participant's sociodemographic data, height, mode of delivery, and neonatal birth weight were obtained using a semistructured proforma. Data analysis was done using the Statistical Package for Social Sciences (IBM-SPSS) version 22, Atlanta, Georgia. Results: The mean age of the study participants was 30.4 ± 4.2 years and the mean height was 164.5 ± 6.1 cm. Approximately 82% of the women had vaginal delivery. Majority (96.6%) of the participants were booked and more than 75% have had previous vaginal delivery. There was no significant association between the maternal height and mode of delivery (P = 0.95). However, there was a significant association between neonatal birthweight and route of delivery (P &lt; 0.001). Conclusion: There is no significant association between maternal height and route of delivery in Abakiliki, Nigeria. Although height has traditionally been used in participant counseling regarding potential route of delivery, this study shows that height may not serve as an evidence-based tool in screening or predicting the route of delivery in the Abakaliki metropolis. Further larger studies are advocated to corroborate or refute this observation

Infant or maternal injury during vaginal delivery is a constant threat to all involved, but difficult to predict. To estimate the risk of birth injuries in an institution favouring trial of vaginal birth when there was doubt of the best mode of delivery. A retrospective cohort study. University Hospital. Singleton 14,359 vaginal deliveries in cephalic presentation during 5(1/2) years. The total caesarean section rate during this period was 9%. The likelihood of injury was evaluated by logistic regression analysis with injury as the dependent variable and maternal height and child birthweight as explanatory variables in birth injury risk estimation. Infant injury defined as one of the following: shoulder dystocia, clavicle fracture or brachial plexus injury; and maternal injury as anal sphincter rupture (ASR). There were a total of 318 infant injuries in 282 infants and 423 ASRs. A strong correlation was found between injury and both fetal macrosomia and short maternal stature, but macrosomia was a stronger indicator of injury. Birth injury risk estimation curves were constructed based on maternal height and birthweight. The present results confirm a strong correlation between fetal macrosomia and short maternal stature and the likelihood of injury during vaginal birth. Risk estimation curves were constructed that might be of great value for the obstetrician in choosing the mode of delivery in these cases.

The Institute of Medicine recommends that short women gain less weight during pregnancy than taller women in order to reduce the risk of high birthweight, which can lead to feto-pelvic disproportion. This recommendation, however, is based on clinical judgment rather than on epidemiologic evidence, as few studies have examined the relationships between maternal height, pregnancy weight gain, and infant birthweight. Our objective was to determine whether maternal height is an independent risk factor for infant birthweight and to assess whether maternal height modifies the effect of pregnancy weight gain on infant birthweight. We examined the relationship between maternal height and infant birthweight in a multi-ethnic cohort of 8,870 women with uncomplicated pregnancies who delivered singleton infants at the University of California, San Francisco, 1980-1990. Using multiple linear regression, we modeled the contribution of height and weight gain to birthweight in four different ethnic groups. Increasing maternal height was significantly and positively associated with infant birthweight in White, Black, and Asian women, but not Hispanic women. The relationship between pregnancy weight gain and infant birthweight was not modified by maternal height. Am. J. Hum. Biol. 12:682-687, 2000. Copyright 2000 Wiley-Liss, Inc.