Short stature: An obstetric risk factor?

Abstract

BACKGROUND: A short maternal stature is associated with an increased risk of obstructed labor due to cephalopelvic disproportion and most antenatal programs, including that of Tanzania, designate short women as 'at risk'. OBJECTIVE: To determine mean maternal height in two obstetric populations and the effect, if any, of maternity care practices pertaining to maternal height, on interventions and outcome of pregnancy and delivery. METHODS: A community based study of pregnancy outcome for women in two villages in rural Tanzania of different profiles and ethnicity. RESULTS: In Ilula 54% of cesarean sections were in the 4% of women under 150 cm and 39% of short women delivered in hospital. In Ikwiriri 23% of parturients were under 150 cm and height did not correlate to the duration of labor, referral patterns or Cesarean section rates. There are indications that fertility rate is reduced in short women in Ilula but not in Ikwiriri, a result of the problems and risks of Cesarean section for women living in rural areas. CONCLUSIONS: The distribution of maternal height in the population should be considered when the cut-off height for the 'at risk' designation is chosen. The implications of attaching an 'at risk' label is discussed and a call is made for regional specific and agreed risk criteria.