The effects of maternal stature and race/ethnicity on adverse birth
outcomes; A retrospective cohort study
Abstract
Objective: To examine the association between maternal stature and
adverse perinatal outcomes, and the modifying effect of race/ethnicity.
Design: Retrospective cohort study. Settings: USA, 2016-2017.
Population: Women with a singleton stillbirth or livebirth
(N=7,361,713). Methods: Using data from the National Center for Health
Statistics, short and tall stature were defined as <10th and
>90th centile of the maternal height distribution. Logistic
regression was used to obtain adjusted odds ratios (AOR) and 95%
confidence intervals (CI). Main Outcome Measures: Preterm birth (PTB,
<37 weeks’ gestation), perinatal death, and the composite of
perinatal death/severe neonatal morbidity (PD/SNM). Results: Short women
had elevated risk of adverse outcomes, while tall women had a decreased
risk relative to average stature women. Short women had an increased
risk of perinatal death and PD/SNM (AOR=1.14, CI: 1.10-1.17; AOR=1.21,
CI: 1.19-1.23, respectively). The association between short stature and
perinatal death was attenuated in non-Hispanic Black women compared with
non-Hispanic White women (AOR=1.10, 95% CI 1.03-1.17 vs AOR=1.26, CI
1.19-1.33). Compared with women of average stature, tall non-Hispanic
White women had lower rates of PTB, PD/SNM (AOR=0.82, CI 0.81-0.83;
AOR=0.95, CI 0.91-1.00; AOR=0.90, CI 0.88-0.93, respectively).
Conclusion: Relative to women of average stature, short women have an
increased risk of adverse perinatal outcomes; these effects are
attenuated in Hispanic women, and for some adverse outcomes in
non-Hispanic Black women. All tall women have a lower risk of preterm
birth, and tall non-Hispanic White women have also lower risk of
perinatal death/severe neonatal morbidity.