Maternal obesity and rate of cesarean delivery in Djibouti

Minsart, Anne-Frédérique; N'guyen, Thai-Son Ts; Dimtsu, Hirut; Ratsimanresy, Rachel R; Dada, Fouad; Hadji, Rachid R Ali

doi:10.1016/j.ijgo.2014.05.011

Cited by 5 publications

(12 citation statements)

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“…Table 3. The main maternal post-operative complications associated with caesarean sections are: surgical site infections, obstetric fi stulae, pulmonary embolism, postpartum haemorrhage, maternal death, and the peroperative complications are anaesthetic complications, complicated haemorrhage in haemostatic hysterectomy and maternal death [10,15,16,19,21,28,33,[37][38][39]45,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] [12,[63][64][65][66][67][68][69][70][71][72][73][74][75]…”

Section: Resultsmentioning

confidence: 99%

An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature

Dikete¹,

Coppieters²,

Trigaux³

et al. 2019

Arch Community Med Public Health

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Introduction:Ensuring access to quality caesarean sections (CS) is a challenge for the next millennium and a sustainable development goal to reduce maternal and infant mortality. A CS involves risks and complications and should therefore be performed in an approved way and not used excessively. The WHO recommends that the CS rate should not exceed 10-15%. Approximately 99% of maternal deaths occur in developing countries where efforts to reduce maternal deaths are still low. This review of the literature aims to provide a summary of CS practices in sub-Saharan Africa and the consequences in terms of morbidity and mortality. Material and Method:The data was collected following the selection criteria on the NCBI's PubMed.Result: Across the four main themes selected for this summary, the frequency of CS varies from 2 to 51%. Indications for caesarean CS are mainly dystocia, foetal distress, scarred uterus, breech presentation, antenatal haemorrhage and hypertensive disorders. Maternal risks related to CS are surgical site infections, obstetric fi stulae, anaesthetic complications, pulmonary embolism, postpartum haemorrhage, haemostatic hysterectomy and maternal death, and the perinatal risks related to CS are respiratory distress, prematurity and perinatal death. Conclusion:In the current working conditions, the risks incurred by the mother and the foetus during a CS are signifi cantly greater than during a vaginal delivery. CS is not yet a factor in reducing maternal and perinatal morbidity and mortality in Sub-Saharan Africa. To reduce maternal and perinatal morbidity and mortality, working conditions at referral centre level, transfer conditions, and improve the training of health staff should be improved. Citation:Dikete M, Coppieters Y, Trigaux P, Englert Y, Simon P, et al. (2019) An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature. Arch Community Med Public Health 5(2): 077-086. DOI: http://dx.References were selected based on the following criteria: the type of study on CS, the target population and the data analysis using the following search terms on PubMed (intraoperative complications, caesarean section, maternal mortality and morbidity, perinatal mortality and morbidity, Africa South of the Sahara) for the period from 2011 to 2016 (the period during which we started missions to support the training of gynaecologists and obstetricians in the east of the Democratic Republic of the Congo). The following inclusion criteria were applied: articles focusing essentially on the CS, the indications for a CS, and maternal and perinatal complications associated with CS in sub-Saharan Africa. The studies selected were retrospective, prospective, clinical trials and ecological studies. Clinical cases were excluded from this review. The target population is the population of sub-Saharan Africa: the population studied was composed of women who had a CS delivery and their new-borns infants. The registrations of the participants involved in the various studies were examined...

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Section: Resultsmentioning

confidence: 99%

An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature

Dikete¹,

Coppieters²,

Trigaux³

et al. 2019

Arch Community Med Public Health

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“…All the included studies were observational studies except for Davies et al, [47] which was a sub-study of a randomised controlled trial (Table 3). Three of the studies used a case-control design [39,40,45], six studies used a cross-sectional design [38,44,46,50,52,53], and seven studies used a cohort design [10,[41][42][43]48,49,51].…”

Section: Methodsmentioning

confidence: 99%

“…Most of the studies were conducted in Nigeria (6/17) [39][40][41][42][43][44]; and South Africa (3/17) [45][46][47] (Table 3). Twelve of the included studies were conducted either in tertiary health centres or maternity clinics [10,[39][40][41][42][43]45,46,[48][49][50][51]; while the other 5 studies were conducted in community or neighbourhood settings [38,44,47,52,53].…”

Section: Study Settingmentioning

confidence: 99%

“…Seven studies recorded participants' BMI at the first antenatal booking without stating a specific gestational age [40,41,[45][46][47][48]50]. Minsart et al, [10] compared caesarean outcomes for BMI at ≤14 weeks, ≤22 weeks, and at delivery. Two other studies measured maternal BMI at ≤25 weeks [42] and ≤32 weeks [39].…”

Section: Populationmentioning

confidence: 99%

“…Although maternal obesity is assessed differently worldwide, pre-pregnancy and first trimester BMI are the most commonly employed evaluation tools [9]. However, studies have reported maternal BMI at different gestational time points because in low resource settings, the first prenatal visit, when maternal BMI is commonly determined, often occurs after first trimester [10].…”

Section: Introductionmentioning

confidence: 99%

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Maternal Obesity as a Risk Factor for Caesarean Delivery in Sub-Saharan Africa: A Systematic Review

Brizan

Amabebe

2022

Life

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Background: Maternal obesity is associated with several adverse reproductive outcomes. It is a growing public health burden in sub-Saharan Africa, a region with low resources and capacity to care for the large, affected population. Objectives: To assess the evidence of maternal obesity as a risk factor for caesarean delivery in women in sub-Saharan Africa. Methods: A systematic review of relevant original articles using PubMed, MEDLINE, and CINAHL was performed. Google Scholar and the reference lists of relevant systematic reviews and meta-analyses were also searched for other eligible studies. Observational studies assessing maternal body mass index (BMI) ≥ 30 kg/m2 before or during gestation and caesarean delivery as birth outcome were included. Results: All 17 studies were published between 2009 and 2021 and included 227,675 (236–153,102) participants. The prevalence of maternal obesity ranged from 3.9 to 44%. All except two studies (88%) indicated an association of obesity and risk of caesarean delivery in pregnant women in sub-Saharan Africa. Overweight/obese women had up to 4-fold increased risk of caesarean delivery compared to normal weight women. Three studies also reported a direct relationship between morbid obesity and prevalence of caesarean delivery in the sub-region. The risk of caesarean delivery appears to increase with increasing BMI e.g., >5 times in women with BMI ≥ 40 kg/m2 than in normal weight women. Conclusions: In sub-Saharan Africa, increased BMI in pregnancy is a risk factor for subsequent caesarean delivery. The risk of caesarean delivery appears to increase with increasing BMI. A robust meta-analysis and other patho-mechanistic studies can be conducted to confirm causal association. Culturally appropriate weight management and nutritional interventions should be implemented to reduce the incidence of obesity-induced caesarean delivery in sub-Saharan Africa.

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The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

Wells

2017

The Anatomical Record

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The "obstetrical dilemma" refers to the tight fit between maternal pelvic dimensions and neonatal size at delivery. Most interest traditionally focused on its generic significance for humans, for example our neonatal altriciality and our complex and lengthy birth process. Across contemporary populations, however, the obstetrical dilemma manifests substantial variability, illustrated by differences in the incidence of cephalo-pelvic disproportion, obstructed labour and cesarean section. Beyond accounting for 12% of maternal mortality worldwide, obstructed labour also imposes a huge burden of maternal morbidity, in particular through debilitating birth injuries. This article explores how the double burden of malnutrition and the global obesity epidemic may be reshaping the obstetrical dilemma. First, short maternal stature increases the risk of obstructed labour, while early age at marriage also risks pregnancy before pelvic growth is completed. Second, maternal obesity increases the risk of macrosomic offspring. In some populations, short maternal stature may also promote the risk of gestational diabetes, another risk factor for macrosomic offspring. These nutritional influences are furthermore sensitive to social values relating to issues such as maternal and child nutrition, gender inequality and age at marriage. Secular trends in maternal obesity are substantially greater than those in adult stature, especially in low-and middle-income countries. The association between the dual burden of malnutrition and the obstetrical dilemma is therefore expected to increase, because the obesity epidemic is emerging faster than stunting is being resolved. However, we currently lack objective population-specific data on the association between maternal obesity and birth injuries. Anat Rec, 300:716-731,

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Maternal obesity and rate of cesarean delivery in Djibouti

Abstract: 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.

Cited by 5 publications

References 12 publications

An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature

An analysis of the practices of caesarean section in sub-Saharan Africa: A summary of the literature

Maternal Obesity as a Risk Factor for Caesarean Delivery in Sub-Saharan Africa: A Systematic Review

The New “Obstetrical Dilemma”: Stunting, Obesity and the Risk of Obstructed Labour

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