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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 4

Category: Diabetes

Poster Session 4

(1072) Can Maternal Height and Fetal Head Circumference Predict Labor Dystocia? An Evaluation of Diabetic Patients

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:

Labor dystocia (LD) is a leading cause for cesarean delivery (CD). Maternal anthropometrics are known determinants of delivery outcomes. Recent data suggest that fetal head circumference-to-maternal height ratio (HC/MHr) exceeding 2.09, outperforms either parameter alone in predicting LD. This study aimed to assess whether HC/MHr can predict CD for LD among patients with gestational diabetes mellitus (GDM) undergoing induction of labor (IOL).

Study Design:

A retrospective cohort study of all GDM patients who underwent IOL between 2014 and 2023 at a tertiary hospital. All patients had pre-IOL sonographic fetal biometry, including head circumference, biparietal diameter, femur length, and abdominal circumference. The cohort was divided into two groups based on HC/MHr: high HC/MHr ( >2.09) and low HC/MHr (≤2.09). Maternal and obstetric characteristics, as well as delivery outcomes, were compared between groups. The predictive performance of HC/MHr for CD due to LD was assessed using receiver operating characteristic (ROC) curve analysis.

Results:

Among 845 patients, 693 (82.0%) achieved vaginal delivery, while 141 (16.9%) underwent CD, 77 (9.1%) for LD. Compared to the low-ratio group, the high HC/MHr group had higher obesity rates (43.2% vs. 33.8%, p=0.019) but lower rates of nulliparity (30.7% vs. 39.1%, p=0.013) and hypertensive disorders (7.2% vs. 15.1%, p< 0.001). Labor characteristics and delivery outcomes were similar between groups. In a multivariable analysis adjusted for potential confounders, HC/MH >2.09 was independently associated with an increased risk of CD for LD (adjusted odds ratio 1.87; 95% CI, 1.02–3.42; p=0.04). However, the discriminative ability of HC/MHr was limited (AUC = 0.51).

Conclusion:

Among GDM patients undergoing IOL, a high HC/MHr was independently associated with an increased risk of CD for LD, but had poor predictive value, limiting its utility as a screening tool.