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dc.contributor.authorWells, Jonathan C. K.
dc.contributor.authorMarphatia, Akanksha A.
dc.contributor.authorCortina‐Borja, Mario
dc.contributor.authorManandhar, Dharma S.
dc.contributor.authorReid, Alice M.
dc.contributor.authorSaville, Naomi
dc.date.accessioned2021-11-12T16:47:40Z
dc.date.available2021-11-12T16:47:40Z
dc.date.issued2021-01-15
dc.date.submitted2020-06-09
dc.identifier.issn1042-0533
dc.identifier.issn1520-6300
dc.identifier.otherajhb23566
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330587
dc.description.abstractAbstract: Objectives: Evolutionary perspectives on human childbirth have primarily focused on characteristics of our species in general, rather than variability within and between contemporary populations. We use an evolutionary framework to explore how physical and demographic characteristics of mothers shape the risks of childbirth complications in rural lowland Nepal, where childbearing typically commences in adolescence and chronic undernutrition is widespread, though maternal overweight is increasing in association with nutrition transition. Methods: We conducted secondary analyses of data from a cluster‐randomized trial. Women aged 14–35 years were categorized by age, number of previous pregnancies, height, body mass index (BMI), husband's education, and household wealth. Multivariable logistic regression models tested whether these characteristics independently predicted risks of episiotomy and cesarean section (CS, n = 14 261), and obstructed labor (OL, n = 5185). Results: Risks were greatest among first‐time adolescent mothers, though associations with age varied by outcome. Independent of age and parity, short stature and high BMI increased risks of CS and OL, whereas associations were weaker for episiotomy. Male offspring had increased risk of CS and OL but not episiotomy. Wealth was not associated with OL, but lower wealth and lower husband's education were associated with lower likelihood of episiotomy and CS. Conclusions: At the individual level, the risk childbirth complications is shaped by trade‐offs between fertility, growth, and survival. Some biological markers of disadvantage (early childbearing, short stature) increased the risk, whereas low socio‐economic status was associated with lower risk, indicating reduced access to relevant facilities. Independent of these associations, maternal age showed complex effects.
dc.languageen
dc.publisherJohn Wiley & Sons, Inc.
dc.subjectORIGINAL RESEARCH ARTICLE
dc.subjectORIGINAL RESEARCH ARTICLES
dc.titleMaternal physical, socioeconomic, and demographic characteristics and childbirth complications in rural lowland Nepal: Applying an evolutionary framework to understand the role of phenotypic plasticity
dc.typeArticle
dc.date.updated2021-11-12T16:47:39Z
prism.issueIdentifier6
prism.publicationNameAmerican Journal of Human Biology
prism.volume33
dc.identifier.doi10.17863/CAM.78031
dcterms.dateAccepted2020-12-22
rioxxterms.versionofrecord10.1002/ajhb.23566
rioxxterms.versionAO
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidWells, Jonathan C. K. [0000-0003-0411-8025]
dc.contributor.orcidSaville, Naomi [0000-0002-1735-3684]
pubs.funder-project-idLeverhulme Trust (RPG‐2017‐264)


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