Abstract
Objective To test the hypothesis that maternal height is associated with adverse perinatal
outcomes, controlling for and stratified by maternal body mass index (BMI).
Study Design This was a retrospective cohort study of all births in California between 2007 and
2010 (n = 1,775,984). Maternal height was categorized into quintiles, with lowest quintile
(≤20%) representing shorter stature and the uppermost quintile (≥80%) representing
taller stature. Outcomes included gestational diabetes mellitus (GDM), preeclampsia,
cesarean, preterm birth (PTB), macrosomia, and low birth weight (LBW). We calculated
height/outcome associations among BMI categories, and BMI/outcome associations among
height categories, using various multivariable logistic regression models.
Results Taller women were less likely to have GDM, nulliparous cesarean, PTB, and LBW; these
associations were similar across maternal BMI categories and persisted after multivariable
adjustment. In contrast, when stratified by maternal height, the associations between
maternal BMI and birth outcomes varied by specific outcomes, for example, the association
between morbid obesity (compared with normal or overweight) and the risk of GDM was
weaker among shorter women (adjusted odds ratio [aOR], 95% confidence interval [CI]:
3.48, 3.28–3.69) than taller women (aOR, 95% CI: 4.42, 4.19–4.66).
Conclusion Maternal height is strongly associated with altered perinatal risk even after accounting
for variations in complications by BMI.
Keywords
cesarean - gestational diabetes - maternal height - obesity
