METHODS: The medical records of singleton deliveries with adverse obstetric outcomes related to labor dystocia during 2014-2020, in a single tertiary center, were reviewed. Outcomes included at least one of the following: cesarean delivery (CD) due to cephalopelvic disproportion (CPD), prolonged second stage, shoulder dystocia, third- or fourth-degree perineal tear. Maternal short stature was defined as height below the 10th centile (short stature group) and normal stature was defined as maternal height between the 10th and 90th centiles (normal stature group). Maternal and neonatal characteristics were compared between the groups.
RESULTS: A total of 3295 women were included, among them, 307 in the short stature group (9.3%, height 1.52 ± 0.02 m) and 2988 in the normal stature group (90.7%, height 1.63 ± 0.04 m). Evaluating the entire cohort revealed similar neonatal birth weights comparing the short and normal stature groups. A subgroup analysis of women after CD due to CPD (n = 296) revealed lower neonatal birth weights in the short stature group (n = 31) compared with the normal stature group (n = 265) (3215 ± 411 vs 3484 ± 427 g, P = 0.001, respectively). Multivariable linear regression was performed for women who underwent CD due to CPD. After adjusting for obesity and diabetes mellitus, short stature and nulliparity were found to be independently associated with decreased neonatal birth weight (266 g less for short stature, P = 0.001, and 294 g less for nulliparity, P = 0.001).
CONCLUSIONS: Among women with short stature, CD due to CPD occurs at lower neonatal birth weights.
方法:在2014-2020年期间,在单个三级中心,单胎分娩与分娩难产相关的不良产科结局的医疗记录,被审查了。结果包括以下至少一种:由于头盆比例失调(CPD)引起的剖宫产(CD),延长第二阶段,肩难产,会阴三度或四度撕裂。母亲身材矮小定义为身高低于10百分位数(身材矮小组),正常身材矮小定义为母亲身高在10至90百分位数之间(正常身材矮小组)。比较两组产妇和新生儿的特征。
结果:共纳入3295名妇女,其中,身材矮小组307人(9.3%,身高1.52±0.02m)和正常身材组的2988(90.7%,高度1.63±0.04m)。评估整个队列显示,与矮小和正常身材组相比,新生儿出生体重相似。对CPD引起的CD后妇女的亚组分析(n=296)显示,与正常身材组(n=265)相比,身材矮小组(n=31)的新生儿出生体重较低(3215±411vs3484±427g,分别为P=0.001)。对因CPD而接受CD的女性进行多变量线性回归。调整肥胖和糖尿病后,发现身材矮小和无胎与新生儿出生体重下降独立相关(身材矮小者减少266g,P=0.001,无效时减少294克,P=0.001)。
结论:在身材矮小的女性中,由于CPD引起的CD发生在新生儿出生体重较低时。