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Djibouti, Djibouti

Minsart A.-F.,Affi Hospital | N'guyen T.-S.,Affi Hospital | Ali Hadji R.,Affi Hospital | Caillet M.,Saint Pierre University Hospital
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2015

Objective: The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status. Methods: This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model. Results: Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10-2.27), p value=0.014. Conclusions: Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium. © 2014 Informa UK Ltd. All rights reserved.

Minsart A.-F.,Affi Hospital | N'Guyen T.-S.,Affi Hospital | Dimtsu H.,Affi Hospital | Ratsimanresy R.,Affi Hospital | And 2 more authors.
International Journal of Gynecology and Obstetrics | Year: 2014

Objective: To calculate the prevalence ofmaternal obesity and to determine the relation between obesity and cesarean delivery in an urban hospital in Djibouti.Methods: In an observational cohort study, allwomenwho had a live birth or stillbirth between October 2012 andNovember 2013were considered for inclusion. Bodymass index (BMI, calculated as weight in kilograms divided by the square of height inmeters)was calculated throughout pregnancy, andwomen with a BMI of at least 30.0 were deemed to be obese. Multivariate logistic regression analyses were used to evaluate the relation between cesarean and obesity.Results: Overall, 100 (24.8%) of 404womenwere obese before 14 weeks of pregnancy, as were 112 (25.2%) of 445 before 22 weeks, and 200 (43.2%) of 463 at delivery. Obesity before 22 weeks was associated with a 127% excess risk of cesarean delivery (adjusted odds ratio 2.27; 95% CI 1.074.82; P= 0.032). Similar trends were found when the analyses were limited to the subgroup of women without a previous cesarean delivery or primiparae.Conclusion: Prevalence of maternal obesity is high in Djibouti City and is related to an excess risk of cesarean delivery, even after controlling for a range of medical and socioeconomic variables. © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Minsart A.-F.,Affi Hospital | N'Guyen T.-S.P.,Affi Hospital | Dimtsu H.,Affi Hospital | Ratsimandresy R.,Affi Hospital | And 2 more authors.
Gynecological Endocrinology | Year: 2014

The International Association of Diabetes and Pregnancy Study Groups released new recommendations on screening methods and diagnostic criteria for gestational diabetes. The main objectives of the present study were to analyze characteristics of mothers who underwent the new screening test, and to assess the prevalence of gestational diabetes and related pregnancy complications such as the 5-minute Apgar score <7, in a urban maternity clinic in Djibouti. The effect of treating gestational diabetes was also evaluated. Totally, 231 mothers underwent the new screening test, and 106 were diagnosed as having gestational diabetes (45.9%). Mothers with gestational diabetes had an excess risk of low Apgar scores, even after adjustment for socio-economic and medical covariates, with an odds ratio of 6.34 (1.77-22.66), p value <0.005. Only 46.2% of mothers with gestational diabetes followed the recommendations regarding treatment. Among these patients, 18.6% of infants from untreated mothers had a 5-minute Apgar score <7, compared to 3.9% infants from treated mothers (p value=0.017). After adjustment, untreated mothers still had a high excess risk of low Apgar scores, although non-significant, with an odds ratio of 4.67 (0.78-27.87), p value=0.09. In conclusion, gestational diabetes is highly prevalent in Djibouti and is related to low Apgar scores. © 2014 Informa UK Ltd. All rights reserved.

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