Abstract
Objective
: The present study was aimed to investigate pregnancy outcome of patients with short
stature (height < 155 cm), and specifically to elucidate if patients with short stature are at an increased
risk for Cesarean section (CS) even after controlling for labor dystocia.
Methods
: A population-based study comparing pregnancy outcome of patients with and without
short stature, was performed. Deliveries occurred during the years 1988–2002, in a
tertiary medical center. Stratified analyses, using the Mantel–Haenszel technique,
and a multiple logistic regression model were performed to control for confounders.
Results
: During the study period, 159,210 deliveries occurred. Of these, 5822 (3.65%) were
of patients with short stature. Patients with short stature had statistically significant
higher rates of CS compared with patients ≥155 cm (21.3% versus 11.9%, odds ratio (OR) = 2.0; 95% confidence interval (CI): 1.9–2.1; P < 0.001). Furthermore, there patients had higher rated of previous deliveries by CS
(17.5% versus 10.3%, OR = 1.8; 95% CI: 1.7–2.0; P < 0.001), intrauterine growth restriction (IUGR, 3.2% versus 1.9%, OR = 1.7; 95% CI: 1.4–1.9; P < 0.001), premature rupture of membranes (PROM, 7.1% versus 5.6%, OR = 1.3; 95% CI: 1.2–1.4; P < 0.001), failed induction (0.7% versus 0.4%, OR = 2.0; 95% CI: 1.5–2.8; P < 0.001), labor dystocia (6.1% versus 3.5%, OR = 1.8; 95% CI: 1.6–2.0; P < 0.001), mal-presentations (7.6% versus 6.1%, OR = 1.3; 95% CI: 1.1–1.4; P < 0.001), and cephalopelvic disproportion (CPD, 0.9% versus 0.3%, OR = 2.6; 95% CI: 1.9–3.4; P < 0.001). No significant differences were noted between the groups regarding perinatal
complications such as low birth-weight, meconium-stained amniotic fluid, perinatal
mortality, and low Apgar scores at 5 min. Controlling for possible confounders such as previous CS, IUGR, PROM, failed
induction, labor dystocia, mal-presentations and CPD, using the Mantel–Haenszel technique,
did not change the significant association between short stature and CS. Moreover,
a multiple logistic regression model was constructed with CS as the outcome variable,
controlling for all these confounders. The model found short stature to be an independent
risk factor for CS (OR = 1.7; 95% CI: 1.6–1.9; P < 0.001).
Conclusion
: Short stature is an independent risk factor for Cesarean delivery. Further studies
investigating the actual indication for CS should be performed in order to make an
informed recommendation regarding the preferred mode of delivery in short parturient
women.
Keywords
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Article info
Publication history
Accepted:
September 23,
2004
Received in revised form:
June 6,
2004
Received:
April 18,
2004
Footnotes
☆Presented at the 24th Annual Meeting of the Society of Maternal Fetal Medicine (SMFM), New Orleans, USA, 2–7 February 2004.
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
