(742) Neonatal birthweight thresholds for cephalopelvic disproportion among short and normal stature women

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: Maternal short stature is a known risk factor for birth injuries, shoulder dystocia and cesarean deliveries (CD) due to cephalopelvic disproportion (CPD). Data regarding an association between maternal height, neonatal birthweight (BW) and CPD are insufficient. We aimed to correlate between maternal height and neonatal BW among women undergoing CD only due to CPD.

Study Design: The medical records of all women who had CD due to CPD, after a failed trial of vaginal delivery, during 2014-2020, in a single tertiary center, were reviewed. Multiple pregnancies were excluded. Maternal short stature was defined as maternal height < the 10^th percentile (short stature group) and normal stature was defined as a maternal height between 10^th-90^th percentile (normal stature group). Maternal and neonatal characteristics were compared between groups.

Results: Included 676 women, among them 67 in the short stature group (9.9%, height 1.52 + 0.02m) and 609 in the normal stature group (90.1%, height 1.63m + 0.05m). Maternal and delivery characteristics were similar between the groups, except for higher maternal BMI (kg/m²) in the short stature group as compared to the normal stature group (27.4 + 6.7 vs 25.3 + 5.9 kg/m², p=0.015). Lower neonatal BW and lower rates of macrosomia characterized the short stature group as compared to the normal stature group (mean BW 3328 + 389 g vs 3482 + 444 g, p=0.007, median BW 3292 g vs 3480 g, p=0.008, and 4.5% vs 12.6%, p=0.047, respectively).
Multivariable linear regression analysis, after adjusting for nulliparity, obesity, diabetes mellitus and epidural anesthesia, revealed that only short stature and nulliparity were independently associated with decreased neonatal BW in cases of CPD (short stature decreased BW by 123 g, p=0.043, and nulliparity decreased BW by 163 g, p=0.012).

Conclusion: Among women with short stature, CD due to CPD occurs in lower neonatal BW. Larger cohorts are needed in order to define the exact BW threshold in which an elective induction of labor is justified in short statured women at >39 weeks of gestation.

Primary & Presenting Author(s)

Gal Cohen, MD
The Department of Obstetrics and Gynecology, Meir Medical Centerartment of Obstetrics and Gynecology, Meir Medical Center
Kfar Saba, Israel, Israel

Coauthor(s)

SH
Shalev Ram Hila, MD
Technion
Raanana, Israel
Hanoch Schreiber, MD
The Department of Obstetrics and Gynecology, Meir Medical Centerartment of Obstetrics and Gynecology, Meir Medical Center
Kfar Saba, Israel, Israel
YD
Yair Daykan, MD
Meir Medical Center
Kfar Saba, HaMerkaz, Israel
TB
Tal Biron-Shental, MD
Meir Medical Center
Kfar saba, HaMerkaz, Israel
Michal Kovo, MD, PhD
Vice Chair Obstetrics and Gynecology
Meir Medical Center
Tel Aviv , Israel, Israel