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DOI: 10.1055/s-0040-1717920
Maternal height combined with neonatal weight as a new anthropometric predictor for adverse delivery outcomes
Introduction Elevated maternal pre-pregnancy BMI, gestational weight, and macrosomia, are well known predictors for adverse pregnancy outcome, including cervical, shoulder dystocia and perineal lacerations. We aimed to evaluate the impact of maternal height combined with neonatal weight(MH/NW)on delivery outcomes in a large cohort of singleton pregnancies.
Material and Methods A Database including 429.863 women who delivered in Switzerland from 2005 to 2017, were analyzed. Inclusion criteria were singleton pregnancy in cephalic presentation, birthweight >10th percentile, and gestational age at delivery between 37 0/7 and 42 0/7 weeks of gestation. Exclusion criteria were hypertensive pregnancy complications, abnormal Doppler findings and structural or chromosomal anomalies. Adverse perinatal outcomes were defined with mode of delivery (emergency cesarean section, operative vaginal delivery), umbilical cord arterial pH < 7.15, 5ʹApgar score < 7, admission to the NICU, and/or perinatal mortality. Neonatal weight was defined in grams at the time of delivery.
Results Among 226.935 pregnancies who met the inclusion criteria, the MH/NH was an independent prognostic factor for delivery outcomes, such as shoulder and uterine dystocia (OR1.27(95%CI 1.25,1.29) p< 0.0001 and OR1.06(95%CI 1.01, 1.11) p=0.009, respectively), grade III-IV perineal lacerations (OR1.08(95%CI 1.07,1.09)p< 0.0001), use of Vacuum-assisted vaginal delivery (OR1.027(95%CI 1.022,1.033) p< 0.0001), and cesarean section performed for prolonged labor or failure to progress (OR1.086(95%CI 1.08,1.09)p< 0.0001), at the univariate and multivariate analysis. Furthermore, MH/NW correlated with all these delivery outcomes with an r(correlation coefficient) ranged from 0 and 1, at the Pearson correlation test(p< 0.01).
Conclusion The ratio MH/NW may represent a new anthropometric predictor for adverse delivery outcomes.
Publication History
Article published online:
07 October 2020
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