title: Using survival analysis to determine association between maternal pelvis height and antenatal fetal head descent in Ugandan mothers.
abstract: BACKGROUND
  Fetal head descent is used to demonstrate the maternal pelvis capacity to accommodate the fetal head. This is especially important in low resource settings that have high rates of childbirth related maternal deaths and morbidity. This study looked at maternal height and an additional measure, maternal pelvis height, from automotive engineering. The objective of the study was to determine the associations between maternal: height and pelvis height with the rate of fetal head descent in expectant Ugandan mothers.
  
  
  METHODS
  This was a cross sectional study on 1265 singleton mothers attending antenatal clinics at five hospitals in various parts of Uganda. In addition to the routine antenatal examination, each mother had their pelvis height recorded following informed consent. Survival analysis was done using STATA 12.
  
  
  RESULTS
  It was found that 27% of mothers had fetal head descent with an incident rate of 0.028 per week after the 25th week of pregnancy. Significant associations were observed between the rate of fetal head descent with: maternal height (Adj Haz ratio 0.93 P < 0.01) and maternal pelvis height (Adj Haz ratio 1.15 P < 0.01).
  
  
  CONCLUSIONS
  The significant associations observed between maternal: height and pelvis height with rate of fetal head descent, demonstrate a need for further study of maternal pelvis height as an additional decision support tool for screening mothers in low resource settings.
authors.affiliation: Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala, Uganda.
authors.forename: Ian Guyton
authors.initials: IG
authors.lastname: Munabi
authors.affiliation: Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala, Uganda.
authors.forename: Samuel Abilemech
authors.initials: SA
authors.lastname: Luboga
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, New Mulago Hospital Complex, Kampala, Uganda.
authors.forename: Florence
authors.initials: F
authors.lastname: Mirembe
mesh_terms: D000328:Adult; D001827:Body Height / Q000502:physiology*; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006257:Head; D006801:Humans; D007746:Labor Presentation; D008403:Mass Screening / Q000379:methods; D063130:Maternal Death; D009035:Mothers; D010388:Pelvis / Q000033:anatomy & histology*; D011247:Pregnancy; D016019:Survival Analysis; D014454:Uganda; D055815:Young Adult
keywords: Pelvis height; antenatal diagnosis; childbirth