Cliff-edge model predicts intergenerational predisposition to dystocia and Caesarean delivery

Proceedings of the National Academy of Sciences of the United States of America
Philipp MitteroeckerMihaela Pavlicev

Abstract

Recently, we presented the cliff-edge model to explain the evolutionary persistence of relatively high incidences of fetopelvic disproportion (FPD) in human childbirth. According to this model, the regular application of Caesarean sections since the mid-20th century has triggered an evolutionary increase of fetal size relative to the dimensions of the maternal birth canal, which, in turn, has inflated incidences of FPD. While this prediction is difficult to test in epidemiological data on Caesarean sections, the model also implies that women born by Caesarean because of FPD are more likely to develop FPD in their own childbirth compared with women born vaginally. Multigenerational epidemiological studies indeed evidence such an intergenerational predisposition to surgical delivery. When confined to anatomical indications, these studies report risks for Caesarean up to twice as high for women born by Caesarean compared with women born vaginally. These findings provide independent support for our model, which we show here predicts that the risk of FPD for mothers born by Caesarean because of FPD is 2.8 times the risk for mothers born vaginally. The congruence between these data and our prediction lends support to the cliff-edge m...Continue Reading

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Dec 9, 2016·Proceedings of the National Academy of Sciences of the United States of America·Philipp MitteroeckerMihaela Pavlicev
Feb 9, 2017·Proceedings of the National Academy of Sciences of the United States of America·Philipp MitteroeckerMihaela Pavlicev

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Citations

Feb 28, 2019·American Journal of Human Biology : the Official Journal of the Human Biology Council·Nicole D S GrunstraPhilipp Mitteroecker
Dec 19, 2018·Nature Ecology & Evolution·Philipp Mitteroecker
Apr 10, 2019·Proceedings. Biological Sciences·Eva Zaffarini, Philipp Mitteroecker
Dec 14, 2018·Reproductive Sciences·Santosh JagadeeshanRama S Singh
Feb 20, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Christiana C NygaardUNKNOWN Women's Health. Electronic address: https://i-chorus.org/
Jun 3, 2021·Proceedings. Biological Sciences·Timothy M Waring, Zachary T Wood
Aug 30, 2021·Journal of Human Evolution·Laura T BuckTimothy D Weaver

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