Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma
- PMID:25902498
- PMCID: PMC4426453
- DOI: 10.1073/pnas.1420325112
Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma
Abstract
Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the "obstetric dilemma." Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic-developmental origin of integration.
Keywords: correlational selection; evolution; morphometrics; obstetric dilemma; pelvis.
Conflict of interest statement
The authors declare no conflict of interest.
Figures





Comment in
- Reply to Underdown and Oppenheimer: Roles of selection, plasticity, and genetics in the integration of human pelvis shape and head size.Fischer B, Mitteroecker P.Fischer B, et al.Proc Natl Acad Sci U S A. 2016 Jan 19;113(3):E259. doi: 10.1073/pnas.1520865113. Epub 2016 Jan 11.Proc Natl Acad Sci U S A. 2016.PMID:26755587Free PMC article.No abstract available.
- Do patterns of covariation between human pelvis shape, stature, and head size alleviate the obstetric dilemma?Underdown S, Oppenheimer SJ.Underdown S, et al.Proc Natl Acad Sci U S A. 2016 Jan 19;113(3):E258. doi: 10.1073/pnas.1517524113. Epub 2016 Jan 11.Proc Natl Acad Sci U S A. 2016.PMID:26755595Free PMC article.No abstract available.
Similar articles
- Covariation of fetal skull and maternal pelvis during the perinatal period in rhesus macaques and evolution of childbirth in primates.Kawada M, Nakatsukasa M, Nishimura T, Kaneko A, Morimoto N.Kawada M, et al.Proc Natl Acad Sci U S A. 2020 Sep 1;117(35):21251-21257. doi: 10.1073/pnas.2002112117. Epub 2020 Aug 17.Proc Natl Acad Sci U S A. 2020.PMID:32817513Free PMC article.
- Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma.Pavličev M, Romero R, Mitteroecker P.Pavličev M, et al.Am J Obstet Gynecol. 2020 Jan;222(1):3-16. doi: 10.1016/j.ajog.2019.06.043. Epub 2019 Jun 25.Am J Obstet Gynecol. 2020.PMID:31251927Free PMC article.Review.
- Do patterns of covariation between human pelvis shape, stature, and head size alleviate the obstetric dilemma?Underdown S, Oppenheimer SJ.Underdown S, et al.Proc Natl Acad Sci U S A. 2016 Jan 19;113(3):E258. doi: 10.1073/pnas.1517524113. Epub 2016 Jan 11.Proc Natl Acad Sci U S A. 2016.PMID:26755595Free PMC article.No abstract available.
- The obstetrical dilemma hypothesis: there's life in the old dog yet.Haeusler M, Grunstra NDS, Martin RD, Krenn VA, Fornai C, Webb NM.Haeusler M, et al.Biol Rev Camb Philos Soc. 2021 Oct;96(5):2031-2057. doi: 10.1111/brv.12744. Epub 2021 May 19.Biol Rev Camb Philos Soc. 2021.PMID:34013651Free PMC article.
- Evolution of the human birth canal.Mitteroecker P, Fischer B.Mitteroecker P, et al.Am J Obstet Gynecol. 2024 Mar;230(3S):S841-S855. doi: 10.1016/j.ajog.2022.09.010. Epub 2023 Jul 18.Am J Obstet Gynecol. 2024.PMID:38462258Review.
Cited by
- Obstetrical Constraints and the Origin of Extended Postnatal Brain Maturation in Hominin Evolution.Frémondière P, Haeusler M, Thollon L, Webb NM, Marchal F.Frémondière P, et al.Biology (Basel). 2024 May 31;13(6):398. doi: 10.3390/biology13060398.Biology (Basel). 2024.PMID:38927278Free PMC article.
- No birth-associated maternal mortality in Japanese macaques (Macaca fuscata) despite giving birth to large-headed neonates.Pink KE, Fischer B, Huffman MA, Miyabe-Nishiwaki T, Suda-Hashimoto N, Kaneko A, Wallner B, Pflüger LS.Pink KE, et al.Proc Natl Acad Sci U S A. 2024 Oct 15;121(42):e2316189121. doi: 10.1073/pnas.2316189121. Epub 2024 Oct 7.Proc Natl Acad Sci U S A. 2024.PMID:39374390Free PMC article.
- Covariation of fetal skull and maternal pelvis during the perinatal period in rhesus macaques and evolution of childbirth in primates.Kawada M, Nakatsukasa M, Nishimura T, Kaneko A, Morimoto N.Kawada M, et al.Proc Natl Acad Sci U S A. 2020 Sep 1;117(35):21251-21257. doi: 10.1073/pnas.2002112117. Epub 2020 Aug 17.Proc Natl Acad Sci U S A. 2020.PMID:32817513Free PMC article.
- Transgenerational propensities for infant birth weight reflect fetal growth history of the mother in rhesus monkeys.Shirtcliff EA, Lubach GR, Mooney R, Beck RT, Fanning LK, Coe CL.Shirtcliff EA, et al.Trends Dev Biol. 2019 Dec;12:55-65.Trends Dev Biol. 2019.PMID:32616989Free PMC article.
- Adult pelvic shape change is an evolutionary side effect.Mitteroecker P, Fischer B.Mitteroecker P, et al.Proc Natl Acad Sci U S A. 2016 Jun 28;113(26):E3596. doi: 10.1073/pnas.1607066113. Epub 2016 Jun 21.Proc Natl Acad Sci U S A. 2016.PMID:27330108Free PMC article.No abstract available.
References
- Wittman AB, Wall LL. The evolutionary origins of obstructed labor: Bipedalism, encephalization, and the human obstetric dilemma. Obstet Gynecol Surv. 2007;62(11):739–748. - PubMed
- Schultz AH. The Life of Primates. Universe Books; New York: 1969.
- Say L, et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–e333. - PubMed
- Murray CJL, Lopez AD, editors. The Global Burden of Disease. A Comprehensive Assessment of Mortality and Disability From Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. World Health Organization; Geneva, Switzerland: 1996.
- Dolea C, AbouZhar C. Global Burden of Obstructed Labour in the Year 2000. World Health Organisation; Geneva, Switzerland: 2003.
Publication types
MeSH terms
Associated data
Related information
LinkOut - more resources
Full Text Sources
Other Literature Sources