Short stature and high BMI up risk of cesarean

High body mass index (BMI) and short stature are risk factors for cesarean delivery across all racial/ethnic groups, according to a study to be presented at 34th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting on February 7, 2014 in New Orleans.

Performed in California, the retrospective study looked at outcomes in a cohort of non-anomalous nulliparous, term, singleton, vertex (NTSV) deliveries in 2007. Data from linked birth certificates and patient discharge records were analyzed and maternal height was divided into tertiles: short (<5’3”), average (5’3” – 5’5”), and tall (>5’5”). The investigators calculated prevalence of cesarean delivery in NTSV, stratifying by prepregnancy BMI category, height category, and race/ethnicity. Chi-square tests compared the outcome between height categories.

Researchers found that short stature and maternal obesity were consistently linked with higher risks of cesarean delivery in the NTSV population. The association existed in all studied racial groups, but rates of cesarean were higher for African-American women than for other racial groups. In short, obese women, incidence of cesarean delivery ranged from 42% in Hispanics to 55% in African-American women. Short stature had a substantial impact on cesarean delivery (adjust odds rate [aOR], 1.35; 95% confidence interval [CI], 1.32-1.39) when compared with average height. The impact of overweight (aOR, 1.48; 95% CI, 1.44-1.53) and obesity (aOR, 2.41; 95% CI, 2.33-2.49) on cesarean, however, was even greater.

[Higher maternal BMI linked to fetal death, stillbirth]

The study authors, who included Contemporary OB/GYN Editorial Board member Elliott K. Main, MD, concluded that short stature and high BMI increased risk of cesarean delivery. They urged providers to consider not only BMI, but also the mother’s stature when managing a pregnancy.

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