Predicting Cesarean Delivery in Nulliparous Women: The Role of Maternal Anthropometric Traits and Fetal Birth Weight

Author(s):

Olufemi Adedayo Adegbaye, Ayokunle Moses Olumodeji*, Olumide Emmanuel Adewara, Idowu Oluwaseyi Adebara, Adebayo Augustine Adeniyi, Adewummi Bakare, Sunday Babatunde Awoyinka, Olabisi Timothy Adeyemo, Olumide Mojisola Ayankunle and Taiwo Olufunmilayo Kuye-kuku

Background: The rate of caesarean section has increased rapidly in many parts of the world, and now it is one of the most commonly performed operations.

Aim: The study aimed to evaluate the role of maternal and fetal anthropometric parameters as possible predictors for cesarean delivery in nulliparous women.

Method: This was a comparative cross-sectional study, over a 9-month period, at the Federal Teaching Hospital Ido-Ekiti and Ekiti State University Teaching Hospital Ado-Ekiti, in which 700 nulliparous women in labour with cephalic presenting, singleton fetus at term were recruited and their mode of delivery noted. Study participants had their weight, body mass index, height, mid-upper arm circumference and new-born birth weight determined. These anthropometric parameters in women who achieved vaginal delivery were compared in women who had dystocia-indicated caesarean delivery. Women who had assisted vaginal delivery and emergency caesarean section due to a non-dystocia indication were excluded. The data obtained were analyzed using independent t-test, fisher’s exact test, chi-square and binary logistic regression at significance level of p<0.05 and 95% confidence interval.

Results: Three hundred and forty-six nulliparous women who had spontaneous vaginal delivery were compared with 354 nulliparous women who had caesarean delivery. The mean ages of those who had caesarean section and vaginal deliveries were 28.32 ± 83.86 years and 27.62 ± 4.04 years respectively. Predictors of caesarean section were height ≤ 150 cm (OR=10.831, P=0.001), maternal weight in 1st trimester ≥ 90 kg (OR=13.157, P=0.001), obesity (OR=56.617, P=0.001) (MUAC) >24 cm (OR=0.866, P=0.010) and birth-weight >3500 g (OR=0.108, P=0.001). There was no association between caesarean delivery rate and maternal age, gestational age at presentation, maternal weight at term, maternal weight gain and baby’s gender.

Conclusion: Obesity, short-stature and maternal weight of >90 kg in the first trimester in nulliparous pregnant women are factors associated with increased risk of caesarean delivery.