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Estimating the impact of pelvic immaturity and young maternal age on fetal malposition.
MedLine Citation:
PMID:  22535195     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Fetal malposition, specifically occiput posterior and transverse (OP/OT), is associated with higher intra-partum morbidity. We tested the hypothesis that young maternal age and pelvic immaturity are risk factors for fetal malposition. METHODS: In a cohort study of all nulliparous teen (≤18 years) deliveries over a 4-year period at one institution, fetal head position at time of delivery was collected and correlated with maternal characteristics and outcome data. Using Risser staging observations, pelvic maturity age was set at 16, and accordingly, the women were divided into two groups (younger vs. older teens). Analysis was performed using Fisher's exact, student t test, and logistic regression modeling. RESULTS: Older teen mothers (16-18 years, n = 609) had higher rates of malposition (22 vs. 12 %, p = 0.02) when compared with younger teens (≤15 years, n = 98). Among all women with a malpositioned fetus, older teens had a higher body mass index (BMI: 32.6 ± 6.7 vs. 28.5 ± 3.5, p = 0.04) and subsequent need for cesarean delivery (69 vs. 33 %, p = 0.02) when compared with their younger counterparts. Although younger teens were more successful in having a vaginal delivery (67 %) with an OP/OT position, it was at the expense of a 25 % rate of severe perineal laceration (third/fourth degree). CONCLUSION: Obesity, and not young maternal age or pelvic immaturity, is associated with fetal malposition. The direct association with increasing pre-pregnancy BMI and the long-term impacts of the high rates of cesarean delivery in this young population underscores the need for more public health focus.
Authors:
Sina Haeri; Arthur M Baker
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-26
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  -     ISSN:  1432-0711     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, One Baylor Plaza, MS: BCM 610, Houston, TX, 77030, USA, SinaHaeri@Gmail.com.
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