Kuritani Yoshihiro, Hayashi Shusaku, Yamamoto Ryo, Mitsuda Nobuaki, Ishii Keisuke
Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.
J Obstet Gynaecol Res. 2020 Dec;46(12):2645-2650. doi: 10.1111/jog.14511. Epub 2020 Oct 1.
The primary aim of this study was to examine the association between maternal height and mode of delivery in nulliparous Japanese women. The secondary aim was to examine the association between maternal height and maternal and neonatal morbidities.
This retrospective cohort study included women who gave birth at Osaka Women's and Children's Hospital, a tertiary perinatal center in Japan, from January 2015 to December 2017. Nulliparous Japanese women with singleton gestation, who went into labor at term were included in the study. The primary outcome was mode of delivery, and the secondary outcomes were maternal and neonatal morbidities. The relationships between maternal height and the outcomes were evaluated using multivariate logistic regression analysis adjusted for potential confounders. Maternal height was categorized into five groups with 5-cm increments for the analysis.
A total of 1593 women were analyzed in this study. Shorter women had higher rate of cesarean delivery (CD) than taller women. There were no significant differences in the rates of operative vaginal delivery, maternal morbidity and neonatal morbidity among the maternal-height groups. The adjusted odds ratios (95% confidential interval) of maternal heights of <150 cm, 150-154 cm, 160-164 cm and ≥165 cm for CD, compared with a maternal height of 155-159 cm, were 3.56 (1.79-7.09), 1.68 (1.06-2.64), 0.63 (0.40-1.00) and 0.57 (0.30-1.01), respectively.
Shorter nulliparous Japanese women were more likely to undergo intrapartum CD. However, the rates of maternal and neonatal morbidities in shorter women were similar to those in taller women.
本研究的主要目的是探讨日本初产妇的身高与分娩方式之间的关联。次要目的是研究产妇身高与孕产妇及新生儿发病率之间的关系。
这项回顾性队列研究纳入了2015年1月至2017年12月在日本三级围产期中心大阪妇女儿童医院分娩的妇女。研究对象为单胎妊娠、足月分娩的日本初产妇。主要结局是分娩方式，次要结局是孕产妇及新生儿发病率。采用多因素logistic回归分析评估产妇身高与结局之间的关系，并对潜在混杂因素进行校正。分析时将产妇身高分为五组，每组间隔5厘米。
本研究共分析了1593名妇女。身材较矮的妇女剖宫产率高于身材较高的妇女。在不同身高组之间，阴道助产率、孕产妇发病率和新生儿发病率无显著差异。与身高为155 - 159厘米的产妇相比，身高<150厘米、150 - 154厘米、160 - 164厘米和≥165厘米的产妇剖宫产的校正比值比（95%置信区间）分别为3.56（1.79 - 7.09）、1.68（1.06 - 2.64）、0.63（0.40 - 1.00）和0.57（0.30 - 1.01）。
身材较矮的日本初产妇更有可能在分娩时接受剖宫产。然而，身材较矮的妇女的孕产妇及新生儿发病率与身材较高的妇女相似。
