@article{fdi:010057289,
  title = {{M}aternal and perinatal outcomes by mode of delivery in {S}enegal and {M}ali : a cross-sectional epidemiological survey},
  author = {{B}riand, {V}al{\'e}rie and {D}umont, {A}lexandre and {A}brahamowicz, {M}. and {S}ow, {A}. and {T}raor{\'e}, {M}. and {R}ozenberg, {P}. and {W}atier, {L}. and {F}ournier, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {I}n the context of rapid changes regarding practices related to delivery in {A}frica, we assessed maternal and perinatal adverse outcomes associated with the mode of delivery in 41 referral hospitals of {M}ali and {S}enegal. {S}tudy {D}esign: {C}ross-sectional survey nested in a randomised cluster trial (1/10/2007-1/10/2008). {T}he associations between intended mode of delivery and (i) in-hospital maternal mortality, (ii) maternal morbidity (transfusion or hysterectomy), (iii) stillbirth or neonatal death before {D}ay 1 and (iv) neonatal death between 24 hours after birth and hospital discharge were examined. {W}e excluded women with immediate life threatening maternal or fetal complication to avoid indication bias. {T}he analyses were performed using hierarchical logistic mixed models with random intercept and were adjusted for women's, newborn's and hospitals' characteristics. {R}esults: {A}mong the 78,166 included women, 2.2% had a pre-labor cesarean section ({CS}) and 97.8% had a trial of labor. {A}mong women with a trial of labor, 87.5% delivered vaginally and 12.5% had intrapartum {CS}. {P}re-labor {CS} was associated with a marked reduction in the risk of stillbirth or neonatal death before {D}ay 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 {D}ay 1 ({OR} = 1.3 (0.66-2.72]) differed significantly between groups. {A}mong 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 {D}ay 1, as compared with spontaneous vaginal delivery. {C}onclusions: {I}n referral hospitals of {M}ali and {S}enegal, pre-labor {CS} is a safe procedure although intrapartum {CS} and operative vaginal delivery are associated with increased risks in mothers and infants. {F}urther 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.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {7},
  numero = {10},
  pages = {e47352},
  ISSN = {1932-6203},
  year = {2012},
  DOI = {10.1371/journal.pone.0047352},
  URL = {https://www.documentation.ird.fr/hor/fdi:010057289},
}