Maternal and Perinatal Outcomes by Mode of Delivery in Senegal and Mali: A Cross-Sectional Epidemiological Survey
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{"title"=>"Maternal and Perinatal Outcomes by Mode of Delivery in Senegal and Mali: A Cross-Sectional Epidemiological Survey", "type"=>"journal", "authors"=>[{"first_name"=>"Valérie", "last_name"=>"Briand", "scopus_author_id"=>"15022008000"}, {"first_name"=>"Alexandre", "last_name"=>"Dumont", "scopus_author_id"=>"7102787947"}, {"first_name"=>"Michal", "last_name"=>"Abrahamowicz", "scopus_author_id"=>"7005870441"}, {"first_name"=>"Amadou", "last_name"=>"Sow", "scopus_author_id"=>"55386073100"}, {"first_name"=>"Mamadou", "last_name"=>"Traore", "scopus_author_id"=>"7006005025"}, {"first_name"=>"Patrick", "last_name"=>"Rozenberg", "scopus_author_id"=>"7005123309"}, {"first_name"=>"Laurence", "last_name"=>"Watier", "scopus_author_id"=>"6602839434"}, {"first_name"=>"Pierre", "last_name"=>"Fournier", "scopus_author_id"=>"7202880199"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84867299006", "sgr"=>"84867299006", "pui"=>"365821592", "pmid"=>"23056633", "doi"=>"10.1371/journal.pone.0047352"}, "id"=>"5c820cc0-78b8-3065-ae09-d7e4aac5018d", "abstract"=>"OBJECTIVE: In the context of rapid changes regarding practices related to delivery in Africa, we assessed maternal and perinatal adverse outcomes associated with the mode of delivery in 41 referral hospitals of Mali and Senegal.\\n\\nSTUDY DESIGN: Cross-sectional survey nested in a randomised cluster trial (1/10/2007-1/10/2008). The associations between intended mode of delivery and (i) in-hospital maternal mortality, (ii) maternal morbidity (transfusion or hysterectomy), (iii) stillbirth or neonatal death before Day 1 and (iv) neonatal death between 24 hours after birth and hospital discharge were examined. We excluded women with immediate life threatening maternal or fetal complication to avoid indication bias. The analyses were performed using hierarchical logistic mixed models with random intercept and were adjusted for women's, newborn's and hospitals' characteristics.\\n\\nRESULTS: Among the 78,166 included women, 2.2% had a pre-labor cesarean section (CS) and 97.8% had a trial of labor. Among women with a trial of labor, 87.5% delivered vaginally and 12.5% had intrapartum CS. Pre-labor CS was associated with a marked reduction in the risk of stillbirth or neonatal death before Day 1 as compared with trial of labor (OR = 0.2 [0.16-0.36]), though we did not show that maternal mortality (OR = 0.3 [0.07-1.32]) and neonatal mortality after Day 1 (OR = 1.3 (0.66-2.72]) differed significantly between groups. Among women with trial of labor, intrapartum CS and operative vaginal delivery were associated with higher risks of maternal mortality and morbidity, and neonatal mortality after Day 1, as compared with spontaneous vaginal delivery.\\n\\nCONCLUSIONS: In referral hospitals of Mali and Senegal, pre-labor CS is a safe procedure although intrapartum CS and operative vaginal delivery are associated with increased risks in mothers and infants. Further research is needed to determine what aspects of obstetric care contribute to a delay in the provision of intrapartum interventions so that practices may be made safer when they are needed.", "link"=>"http://www.mendeley.com/research/maternal-perinatal-outcomes-mode-delivery-senegal-mali-crosssectional-epidemiological-survey", "reader_count"=>52, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>10, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>8, "Other"=>3, "Student > Master"=>16, "Student > Bachelor"=>3, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>10, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>8, "Other"=>3, "Student > Master"=>16, "Student > Bachelor"=>3, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>4, "Medicine and Dentistry"=>34, "Agricultural and Biological Sciences"=>1, "Neuroscience"=>1, "Business, Management and Accounting"=>1, "Social Sciences"=>4, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>34}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>4}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>4}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>5}}, "reader_count_by_country"=>{"Japan"=>1, "Congo (Dem. Rep.)"=>1, "Peru"=>1}, "group_count"=>4}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/563352"], "description"=>"<p>Crude Odds ratio (ORc), Adjusted Odds ratio (ORa), confidence interval (CI).</p>*<p>For each outcome of interest, the crude OR was corrected for the clustering effect of the facility and was adjusted for the time period (period 1: from October 2007 to March 2008; period 2: from April to October 2008) and the country.</p>**<p>For each outcome of interest, the multivariable analysis was conducted using a hierarchical logistic mixed model with random intercept adjusted for individual and institutional variables (see the list below).</p>$<p>Adjustment for age, parity, previous CS, number of antenatal care visits, any pathology before index pregnancy, any pathology during current pregnancy, vaginal bleeding near full term, pregnancy-induced hypertension, chorioamniotis, referral status, availability of blood services, anaesthetist and obstetrics/gynaecology specialist availability, country and period.</p>&<p>Adjustment for age, parity, number of antenatal care visits, previous CS, any pathology before index pregnancy, any pathology during current pregnancy, vaginal bleeding near full term, pregnancy-induced hypertension, chorioamniotis, referral status, country and period.</p>£<p>Fetal/immediate neonatal death consisted in stillbirth or neonatal death within 24 hours after birth. Adjustment for age, parity, number of antenatal care visits, previous CS, any pathology before index pregnancy, any pathology during current pregnancy, pregnancy-induced hypertension, vaginal bleeding near full term, chorioamniotis, premature rupture of membranes, birth weight, referral status, availability of formal protocols for maternal and neonatal care, anaesthetist and obstetrics/gynaecology specialist availability, country and period.</p>¥<p>Neonatal death after Day 1 consisted in neonatal death that occurred between 24 hours after birth and hospital discharge. Adjustment for age, parity, number of antenatal care visits, previous CS, any pathology before index pregnancy, any pathology during current pregnancy, pregnancy-induced hypertension, vaginal bleeding near full term, chorioamniotis, premature rupture of membranes, birth weight, referral status, availability of formal protocols for maternal and neonatal care, anaesthetist and obstetrics/gynaecology specialist availability, country and period.</p>", "links"=>[], "tags"=>["adjusted", "maternal", "outcomes", "women", "pre-labor", "cesarean", "compared", "operative", "vaginal", "intrapartum", "cs", "spontaneous", "october", "2007-october"], "article_id"=>233819, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352.t005", "stats"=>{"downloads"=>1, "page_views"=>24, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Crude_Odds_ratio_ORc_and_adjusted_Odds_ratio_ORa_of_specific_maternal_and_child_outcomes_in_women_with_pre_labor_cesarean_section_CS_compared_to_women_with_a_trial_of_labor_intention_to_treat_analysis_and_in_women_with_operative_vaginal_delivery_or_intra/233819", "title"=>"Crude Odds ratio (ORc)<sup>*</sup> and adjusted Odds ratio (ORa)<sup>**</sup> of specific maternal and child outcomes in women with pre-labor cesarean section (CS) compared to women with a trial of labor (intention-to-treat analysis), and in women with operative vaginal delivery or intrapartum CS compared to women with spontaneous vaginal delivery (Senegal and Mali, October 2007-October 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-08 01:03:39"}
  • {"files"=>["https://ndownloader.figshare.com/files/298524"], "description"=>"<div><h3>Objective</h3><p>In the context of rapid changes regarding practices related to delivery in Africa, we assessed maternal and perinatal adverse outcomes associated with the mode of delivery in 41 referral hospitals of Mali and Senegal.</p> <h3>Study Design</h3><p>Cross-sectional survey nested in a randomised cluster trial (1/10/2007–1/10/2008). The associations between intended mode of delivery and (i) in-hospital maternal mortality, (ii) maternal morbidity (transfusion or hysterectomy), (iii) stillbirth or neonatal death before Day 1 and (iv) neonatal death between 24 hours after birth and hospital discharge were examined. We excluded women with immediate life threatening maternal or fetal complication to avoid indication bias. The analyses were performed using hierarchical logistic mixed models with random intercept and were adjusted for women's, newborn's and hospitals' characteristics.</p> <h3>Results</h3><p>Among the 78,166 included women, 2.2% had a pre-labor cesarean section (CS) and 97.8% had a trial of labor. Among women with a trial of labor, 87.5% delivered vaginally and 12.5% had intrapartum CS. Pre-labor CS was associated with a marked reduction in the risk of stillbirth or neonatal death before Day 1 as compared with trial of labor (OR = 0.2 [0.16–0.36]), though we did not show that maternal mortality (OR = 0.3 [0.07–1.32]) and neonatal mortality after Day 1 (OR = 1.3 (0.66–2.72]) differed significantly between groups. Among women with trial of labor, intrapartum CS and operative vaginal delivery were associated with higher risks of maternal mortality and morbidity, and neonatal mortality after Day 1, as compared with spontaneous vaginal delivery.</p> <h3>Conclusions</h3><p>In referral hospitals of Mali and Senegal, pre-labor CS is a safe procedure although intrapartum CS and operative vaginal delivery are associated with increased risks in mothers and infants. Further research is needed to determine what aspects of obstetric care contribute to a delay in the provision of intrapartum interventions so that practices may be made safer when they are needed.</p> </div>", "links"=>[], "tags"=>["maternal", "perinatal", "outcomes", "senegal", "cross-sectional", "epidemiological"], "article_id"=>118863, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Maternal_and_Perinatal_Outcomes_by_Mode_of_Delivery_in_Senegal_and_Mali_A_Cross_Sectional_Epidemiological_Survey/118863", "title"=>"Maternal and Perinatal Outcomes by Mode of Delivery in Senegal and Mali: A Cross-Sectional Epidemiological Survey", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-10-08 02:27:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/563254"], "description"=>"<p>CS, cesarean section. <sup>$</sup>Singleton births only.<sup> &</sup>Stillbirth or neonatal death within 24 hours after birth occurred in, respectively, cases. <sup>£</sup>Neonatal death that occurred between 24 hours after birth and hospital discharge.</p>", "links"=>[], "tags"=>["maternal", "outcomes", "october", "2007-october"], "article_id"=>233743, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352.t003", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Specific_maternal_and_child_outcomes_n_by_mode_of_delivery_Senegal_and_Mali_October_2007_October_2008_/233743", "title"=>"Specific maternal and child outcomes (n (%)), by mode of delivery (Senegal and Mali, October 2007-October 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-08 01:02:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/563391"], "description"=>"<p>CS, cesarean section.</p>", "links"=>[], "tags"=>["maternal", "october", "2007-october"], "article_id"=>233880, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352.t004", "stats"=>{"downloads"=>3, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Causes_of_maternal_death_n_by_mode_of_delivery_Senegal_and_Mali_October_2007_October_2008_/233880", "title"=>"Causes of maternal death (n (%)), by mode of delivery (Senegal and Mali, October 2007-October 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-08 01:04:40"}
  • {"files"=>["https://ndownloader.figshare.com/files/563295"], "description"=>"<p>CS, cesarean section.</p>$<p>HIV, chronic respiratory conditions, cardiac or renal diseases, sickle cell trait, chronic hypertension.</p>£<p>Pyelonephritis or urinary infection, chorioamniotis, severe maternal anaemia, malaria, gestational diabetes, suspected intrauterine death, suspected intrauterine growth retardation.</p>¥<p>Live singleton births only.</p>", "links"=>[], "tags"=>["women", "newborns", "october", "2007-october"], "article_id"=>233779, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352.t002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_women_and_newborns_n_by_mode_of_delivery_Senegal_and_Mali_October_2007_October_2008_/233779", "title"=>"Characteristics of women and newborns (n (%)), by mode of delivery (Senegal and Mali, October 2007-October 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-08 01:02:59"}
  • {"files"=>["https://ndownloader.figshare.com/files/563217"], "description"=>"$<p>Other maternal indications: post-term (<i>n = </i>124, 1.1%), maternal request (<i>n = </i>100, 0.9%), vaginal bleeding near full term (<i>n = </i>56, 0.5%), vaginal fistula (<i>n = </i>25, 0.2%), genital infection (<i>n = </i>6, 0.05%), HIV-infection (<i>n = </i>2), premature rupture of membranes (<i>n</i> = 1), CS performed for “other maternal indications” without any accurate diagnosis (<i>n = </i>824, 7.3%).</p>$$<p>Other fetal indications: suspected intrauterine growth retardation (<i>n = </i>20, 0.2%), breech presentation (<i>n = </i>4), CS performed for “other fetal indications” but without any accurate diagnosis (<i>n = </i>377, 3.3%).</p>", "links"=>[], "tags"=>["reported", "indications", "cesarean", "cs", "october", "2007-october"], "article_id"=>233695, "categories"=>["Biotechnology", "Cell Biology", "Medicine"], "users"=>["Valérie Briand", "Alexandre Dumont", "Michal Abrahamowicz", "Amadou Sow", "Mamadou Traore", "Patrick Rozenberg", "Laurence Watier", "Pierre Fournier"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0047352.t001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Main_reported_indications_for_cesarean_section_CS_according_to_the_type_of_CS_n_Senegal_and_Mali_October_2007_October_2008_/233695", "title"=>"Main reported indications for cesarean section (CS) according to the type of CS (n (%)) (Senegal and Mali, October 2007-October 2008).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-08 01:01:35"}

PMC Usage Stats | Further Information

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Relative Metric

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