Short Stature Increases Risk of Cesarean Delivery and Low Birth Weight, Study Finds

India: A study published in the Apollo Medicine revealed that short maternal height (less than 150 cm) is an independent risk factor for cesarean delivery due to cephalopelvic disproportion.

The research also found a significant statistical correlation between shorter mothers and babies with low birth weight. Despite the influence of multiple factors on labor, it is generally reasonable to allow short primigravidae a trial of labor, except in rare cases.

Pregnancy is a natural physiological process that can become complicated by various factors inherent to the woman. Maternal height has long been recognized as an anthropometric factor that can influence obstetric outcomes. Medically, short stature is defined as an adult height that falls more than 2 standard deviations below the mean for one's gender and age. Several studies, including a meta-analysis by the World Health Organization, identify 145 cm as the standard threshold for determining short stature in women.

Maternal height has long been recognized as an important anthropometric factor influencing obstetric outcomes. In a country like India, where antenatal care is frequently provided by traditional birth attendants (dais) in rural areas, there is a pressing need for a consistent, reliable, and straightforward risk indicator to help prevent unnecessary complications.

Apoorva Anil Gummadi et. al. conducted a study to explore the relationship between maternal height and the mode of delivery, considering other intrapartum factors that affect labor and the subsequent outcomes for both mother and newborn.

For this study, all primigravidae at term gestation (over 37 weeks) with a cephalic presentation at the time of admission to the labor suite and no other comorbidities were included. The mode of delivery, maternal outcomes, and neonatal outcomes were recorded.

The key highlights of the study are:

• Among the 680 patients, 104 were categorized into the short-stature group with a height of less than 150 cm, while the remaining 576 were in the tall-stature group with a height above 150 cm.
• The short-stature group had a higher rate of induced labor at 66.35%.
• There was also a higher incidence of emergency lower-segment cesarean sections due to cephalopelvic disproportion (CPD) in the short-stature group, occurring in 60% of cases.
• In contrast, the tall-stature group had a higher incidence of normal labor at 32.99%.

The study concluded that short stature is independently associated with an increased risk of labor induction. Additionally, a significant correlation was found between shorter maternal height and the likelihood of babies being born with lower birth weights. Given that labor is influenced by multiple factors, it may be reasonable to allow all primigravidae, regardless of height, a fair trial of labor, except in rare circumstances. Using a specific height cutoff as a screening tool to identify patients who are at a higher risk of obstetrical complications could be beneficial, as height is one of several factors influencing the mode of delivery and labor outcomes.

Reference

Gummadi AA, Sunkaraneni S, Kuchana SK, Kode R, Riyyan M. Association of Maternal Height with Mode of Delivery and Perinatal Outcome. Apollo Medicine. 2024;21(3):206-211. doi:10.1177/09760016241245605maternal height, obstetric outcomes, short stature, labor induction, neonatal outcome, cephalopelvic disproportion, primigravidae, birth weight, trial of labor, screening tool