Anthropometric measurements as predictors of cephalopelvic disproportion

Benjamin, Santosh; Daniel, Anjali; Kamath, Asha; Vani, R.

doi:10.1111/j.1600-0412.2011.01267.x

Cited by 44 publications

(50 citation statements)

References 21 publications

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“…There were no studies identified examining determinants of caesareans in migrants specifically. However, gestational diabetes mellitus (GDM) and feto-pelvic disproportion are known to complicate delivery and increase the risk of caesarean [104,105] and these are more common in some migrant women [28,39,106]. Reasons for increased risk of GDM in migrants are unknown but might be associated with a genetic pre-disposition, or physiological response to dietary changes; the involvement of a stress response has also been proposed.…”

Section: Discussionmentioning

confidence: 99%

International migration and caesarean birth: a systematic review and meta-analysis

Merry

Small

Blondel

et al. 2013

BMC Pregnancy Childbirth

113

112

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BackgroundPerinatal health disparities including disparities in caesarean births have been observed between migrant and non-migrant women and some literature suggests that non-medical factors may be implicated. A systematic review was conducted to determine if migrants in Western industrialized countries consistently have different rates of caesarean than receiving-country-born women and to identify the reasons that explain these differences.MethodsReports were identified by searching 12 literature databases (from inception to January 2012; no language limits) and the web, by bibliographic citation hand-searches and through key informants. Studies that compared caesarean rates between international migrants and non-migrants living in industrialized countries and that did not have a ‘fatal flaw’ according to the US Preventative Services Task Force criteria were included. Studies were summarized, analyzed descriptively and where possible, meta-analyzed.ResultsSeventy-six studies met inclusion criteria. Caesarean rates between migrants and non-migrants differed in 69% of studies. Meta-analyses revealed consistently higher overall caesarean rates for Sub-Saharan African, Somali and South Asian women; higher emergency rates for North African/West Asian and Latin American women; and lower overall rates for Eastern European and Vietnamese women. Evidence to explain the consistently different rates was limited. Frequently postulated risk factors for caesarean included: language/communication barriers, low SES, poor maternal health, GDM/high BMI, feto-pelvic disproportion, and inadequate prenatal care. Suggested protective factors included: a healthy immigrant effect, preference for a vaginal birth, a healthier lifestyle, younger mothers and the use of fewer interventions during childbirth.ConclusionCertain groups of international migrants consistently have different caesarean rates than receiving-country-born women. There is insufficient evidence to explain the observed differences.

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Section: Discussionmentioning

confidence: 99%

International migration and caesarean birth: a systematic review and meta-analysis

Merry

Small

Blondel

et al. 2013

BMC Pregnancy Childbirth

113

112

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“…Studies done in other settings have recommended the use of maternal height cut offs of <155.5 cm [20], and <162.5 cm [23] for African mothers. Table 4 shows that increasing the maternal height cut off to the ROC optimum cut off of <160.4 cm improves the sensitivity of the test while increasing the false positive rate.…”

Section: Discussionmentioning

confidence: 99%

“…Logistic regression was used to identify predictors of unfavourable outcomes of labour that included: delivery by cesarean section, vaginal delivery of a baby with an APGAR score of ≤7 at 5 min [19] or mother being referred. To obtain predicted probabilities, all the variables with the optimal cut-off that were significant at the 0.20 level in the univariate analysis were included in the subsequent modeling [20]. To cater for the study design and variability in recruitment numbers from the different sites multilevel logistic regression using the gllamm function in STATA was used to calculate the odds ratios with iterations nipped at 60 for final modeling [21].…”

Section: Methodsmentioning

confidence: 99%

“…All simulations for the ROC analysis were done up to 1000 times using the bootstrapping procedures. During analysis, cut off values were generated as part of the ROC analysis with added comparisons with values from literature for maternal weight, maternal pelvis height [22] and maternal height [20, 23]. No distinction was made between normal vaginal and instrumental vaginal deliveries that were grouped together, during analysis, as a single outcome measure, vaginal delivery.…”

Section: Methodsmentioning

confidence: 99%

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A cross sectional study evaluating screening using maternal anthropometric measurements for outcomes of childbirth in Ugandan mothers at term

2015

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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.

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“…Maternal height correlates positively with her pelvic dimensions and is an important predictor of obstructed labor (Connolly and McKenna, 2001; Kjærgaard et al, 2010; Benjamin et al, 2012). Furthermore, in the “head and trunk skeletal size” PC, trunk breadths feature relatively prominently along with head size.…”

Section: Discussionmentioning

confidence: 99%

Relationships of maternal and paternal anthropometry with neonatal body size, proportions and adiposity in an Australian cohort

Pomeroy

Wells²,

Cole³

et al. 2014

American J Phys Anthropol

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The patterns of association between maternal or paternal and neonatal phenotype may offer insight into how neonatal characteristics are shaped by evolutionary processes, such as conflicting parental interests in fetal investment and obstetric constraints. Paternal interests are theoretically served by maximizing fetal growth, and maternal interests by managing investment in current and future offspring, but whether paternal and maternal influences act on different components of overall size is unknown. We tested whether parents' prepregnancy height and body mass index (BMI) were related to neonatal anthropometry (birthweight, head circumference, absolute and proportional limb segment and trunk lengths, subcutaneous fat) among 1,041 Australian neonates using stepwise linear regression. Maternal and paternal height and maternal BMI were associated with birthweight. Paternal height related to offspring forearm and lower leg lengths, maternal height and BMI to neonatal head circumference, and maternal BMI to offspring adiposity. Principal components analysis identified three components of variability reflecting neonatal “head and trunk skeletal size,” “adiposity,” and “limb lengths.” Regression analyses of the component scores supported the associations of head and trunk size or adiposity with maternal anthropometry, and limb lengths with paternal anthropometry. Our results suggest that while neonatal fatness reflects environmental conditions (maternal physiology), head circumference and limb and trunk lengths show differing associations with parental anthropometry. These patterns may reflect genetics, parental imprinting and environmental influences in a manner consistent with parental conflicts of interest. Paternal height may relate to neonatal limb length as a means of increasing fetal growth without exacerbating the risk of obstetric complications. Am J Phys Anthropol 156:625–636, 2015.

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Anthropometric measurements as predictors of cephalopelvic disproportion

Abstract: Maternal anthropometric measurements can predict CPD to some extent. Combining maternal measurements with clinical estimates of fetal weight only enhances the predictive value to a relatively modest degree (positive predictive value 24%).

Cited by 44 publications

References 21 publications

International migration and caesarean birth: a systematic review and meta-analysis

International migration and caesarean birth: a systematic review and meta-analysis

A cross sectional study evaluating screening using maternal anthropometric measurements for outcomes of childbirth in Ugandan mothers at term

Relationships of maternal and paternal anthropometry with neonatal body size, proportions and adiposity in an Australian cohort

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