title: Maternal height, birthweight and cephalo pelvic disproportion in urban Nigeria and rural Malawi.
abstract: BACKGROUND
  Cephalo pelvic disproportion (CPD) has been attributed to short stature. It has been suggested that nutritional supplementation to promote linear growth would increase birthweight and the risk of CPD. The objective of this study was to examine the factors associated with CPD, with particular reference to birthweight, stature, parity and maternal age.
  
  
  METHODS
  Factors associated with CPD were analyzed using data abstracted from a detailed early hospital report from Ibadan, Nigeria and from a recent rural pregnancy study conducted in the Shire Valley, Malawi.
  
  
  RESULTS
  In Nigeria, of 107 CPD cases admitted to hospital in Ibadan during 1953-54, 79% were women > 20 years. Birthweight values increased significantly with age and parity. In 19.6% of cases, the baby had a low birthweight (< 2500 g). In Malawi, among the 1523 women delivering, the incidence of CPD was 2.3%. Of the 35 cases of CPD, only four were adolescents. Birthweights increased with increasing parity, age and height (p < 0.001). In 6.4% of CPD cases, the baby had a low birthweight. Nulliparity (OR 4.0; CI 1.7-9.3; p = 0.0001), birthweight >or= 3400 g (OR 4.6; CI 2.1-10.0; p = 0.0001) and height <or= 154 cm (OR 3.8; CI 1.8-7.9; p = 0.0003) were associated with an increased risk of CPD. Adolescent mothers were less likely to experience CPD (OR 0.3; C.I. 0.8-0.9; p = 0.03).
  
  
  CONCLUSIONS
  Adolescents are not at high risk of CPD. Nutritional supplementation of girls and adolescents should not be discouraged for fear of increasing the risk of CPD by improving birthweight. When CPD is present, it may result from childhood rickets and calcium deficiency.
authors.affiliation: Academic Unit of Obstetrics & Gynecology and Reproductive Health Care, St. Mary's Hospital, University of Manchester, UK.
authors.forename: Loretta
authors.initials: L
authors.lastname: Brabin
authors.forename: Francine
authors.initials: F
authors.lastname: Verhoeff
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Brabin
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001827:Body Height; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D015994:Incidence; D008295:Malawi / Q000453:epidemiology; D008423:Maternal Age; D009035:Mothers; D009549:Nigeria / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology*; D010298:Parity; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012044:Regression Analysis; D012307:Risk Factors; D012423:Rural Health; D014504:Urban Health