Maternal Anthropometric Characteristics and Fetal Birth Weight as Predictors of Cesarean Delivery in Nulliparous Women, with Singletons Pregnancies in Cephalic Presentation: A Cross Sectional Study.

ABSTRACT

Background: Globally, the rate of cesarean delivery is increasing rapidly over the past years. Aim: The study was conducted to investigate the incidence and the predictors for cesarean delivery in nulliparous women at Khartoum Hospital, Sudan. Methods: A prospective cross-sectional hospital-based study was conducted where all parturient nulliparous women delivered in the period between February to April 2012 were included. Socio-demographic characteristics were gathered through structured questionnaires. Maternal anthropometric measures, birth weight, gender and mode of delivery were recorded and compared between those who delivered vaginally and by emergency cesarean delivery. Results: A total of 533 parturient women were enrolled, of these, 147(27.6%) were emergency cesarean delivery. The cesarean delivery rate in nulliparous increased significantly with increased maternal, age ˃ 30 years (OR=2.4, 95% CI= 1.1─5.2, P= 0.032), decreased maternal height < 150 cm (OR=2.4, 95% CI=1.4─4.1, P=0.002), and in increase BMI ≥ 30 Kg/m 2 (OR=2.2, 95% CI=1.1─4. 9, P=0.046) and increase in birth weight > 3750g (OR=2.7, 95% CI=1.1─6.4, P=0.026). There was no association between cesarean delivery rate, mid-upper arm circumference and fetal gender. Conclusion: There was a high incidence of cesarean delivery among nulliparous women especially among elder, obese women, short statue women and with a fetal birth weight > 3750g.