Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol consumption during pregnancy, and seeing whether this consumption influences GDM detection and maternal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pregnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O'Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and general characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Metformin, and if necessary with insulin. For other (normal) women data remained blinded until confinement. Maternal and infant's adverse outcomes such as maternal urinary infection, preeclampsia, cesarean section, intrauterine growth retardation, birth weight < 2500 g, birth weight ≥ 3800 g (as stated > percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hypoglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol consumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more frequent (p = 0.02) among drinkers. GDM's prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alcohol consumers than in abstainers. Risk of this outcome was three times higher when history of family hypertension was present (odds ratio 2.694; CI: 0.536 -13.544). Conclusions: The prevalence of alcohol consumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. Influence of alcohol consumption on birth weight mostly in setting of familial history of hypertension remains to be addressed.

Objective: Our study is intended to evaluate mobility impairment’s level in adult females, their sociodemographic status, knowledge, and practices related to reproductive health in order to provide healthcare givers and policy makers with tools to meet appropriate needs of these vulnerable persons in Kinshasa, DR Congo. Study design: A cross-sectional descriptive study from March 20th 2012 throughout July 20th 2012 concerned 138 physical (non mental) disabled attendees of 7 centers for disabled adults in Kinshasa, DR Congo. Concerns about extend of the disability focused on parts of the body concerned, functional capacity (self walking, crutches, prosthesis, wheel-chairs) and manual freedom. Participants were interviewed using open-ended questions about sociodemographic status, knowledge, and practices related to reproductive health. Issues concerned included age at menarche, age at first sex experience, marital status, education level, employment status, obstetric history, sex abuse, birth control and sexual transmitted diseases. For statistic analysis OR (CI at 95%) was calculated to seek for possible association between physical impairment and parturition’s characteristics. Results: The mean age of the study group (31.1 ± 5.7 years) ranged from 15 to 40 years. Most were affected by legs and the majority (69.1%) needed crutches or wheelchair for moving. Only 21 (15.2%) were married, most (15) of them with a disabled colleague. Mean parity and gravidity were 2.78 ± 2.3 (range 0 - 11) and 3.4 ± 2.5 (range 0 - 12), respectively. Sex experience was initiated at 17.5 ± 3.7 years (range of 12 - 35), 13 (9.4%) had experienced rape, and 37 (26.8%) had (illegally) aborted. Of the 117 women who had had a child 82 (70.7%) had vaginal delivery. In 24 of 34 cesarean sections fetopelvic disproportion or protracted pelvis was the main indication (68.6%), the risk for cesarean section being somewhat related to involvement of 2 legs. Data concerning the issue of knowledge and practices related to reproductive health were very limited and unreliable. Conclusion: Based on the age at menarche, at first intercourse and having had child reflect obvious interest of disabled in sex and reproduction, even if unmarried. Their limited information on reproductive health education results in unplanned pregnancy, unsafe abortion and risk for HIV and other sexual transmitted diseases. The rate of vaginal delivery is likely to redeem own perception on their health status. This could be basis for adhesion to specific programs devoted to physical, psychological, and social limitations.

Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-term gestation and multiparity. At the University Clinics of Kinshasa (UCK), 30 years ago, the frequency of macrosomia was 2.4%. Objectives. To update data on the frequency of macrosomia at UCK, regarding variations in maternal anthropometrics (obesity) and socio-demographic factors. Methods. A cross-sectional study was conducted at UCK from 1 January 2007 to 31 December 2016. Mothers who delivered babies weighing at least 4000 g were included in this study. Results. The frequency of macrosomia was 3.7%. Trend shows a variation of this frequency over time with lowest frequency (2.1%) in 2012 and highest (5.3%) in 2009. The mother average age and parity were 32.3 ± 5.4 years and 3 ± 2, respectively. Pregnancies were complicated by polyhydramnios (48%) and gestational diabetes (19.7%). Caesarean section was performed in 60.5% cases, mainly for macrosomia (47.8%) and 81.6% of newborns had constitutional macrosomia. Adverse obstetrical outcomes of macrosomia were dominated by caesarean section (28.9%), lacerations of birth canal (23%) and neonatal distress (9.2%). Conclusion. Macrosomia remains a constant finding at UCK, and is associated with maternal, fetal and neonatal adverse outcomes. Trend shows a variation of the frequency over time between 2.1% and 5.3%.

The value of predictive equation of birthweight of our model is similar to that of European, American, and Oceanian models, confirming, in our sub-Saharan setting too, the ability of customised birthweight to better identify growth disordered neonates according to their growth potential.

No abstract