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P Thonneau

Publications and source records attributed to P Thonneau.

At least 19 recordsLinked to original sources
PubMed2006

Introduction of an obstetric health information system: results of a pilot study in North Cameroon.

BACKGROUND: International safe motherhood programs have placed increasing emphasis on assessing progress in reducing maternal mortality in developing countries. We assess the feasibility and relevance of an obstetric health information system introduced in Maroua urban district in North Cameroon. METHODS: During the study period, an obstetric observation register was introduced for obstetric data collection, complemented by anthropological case studies on maternal deaths. RESULTS: At the end of the study period, implementation and data collection processes were correctly done, and the overall rate of completion of obstetric registers was 95% (ranging from 82.5% to 98.5% between maternity units). Eight hundred and twenty-six deliveries (n=826) were recorded and evenly distributed over the nine weeks of the study period. Eight women (1%) were transferred from non-surgical to surgical health facilities. Thirteen C-sections (n=13; 1.6%; CI: 0.8-2.7%) mainly in the provincial hospital of Maroua (11/13), and four maternal deaths were recorded, giving a maternal mortality rate of 4/826 (484 for 100,000; CI: 132-1240 for 100,000 deliveries). Nevertheless, anthropological enquiry recorded five maternal deaths during the same study period. Analysis of the geographical origin of these women showed that four of the five came from very remote areas. Rapid analysis and dissemination of results have initiated changes in obstetric practices (introduction of the partograph, modifications in the attitudes of health personnel), and also to the creation of a network between maternity units (those with and without surgical facilities) and provincial health headquarters. CONCLUSION: The introduction and use of a basic obstetric health information system combined with anthropological survey can provide a relatively accurate assessment of the maternal health situation. Such knowledge would be an excellent basis for implementing obstetric networking and relevant tools for active management of the obstetric pyramid at a regional level in developing countries.

Cameroon↗
PubMed2005

Paternal age: are the risks of infecundity and miscarriage higher when the man is aged 40 years or over?

BACKGROUND: Maternal age of 35 years or over is a well-known risk factor for human reproduction that has been extensively investigated by demographers and epidemiologists. However, the possibility of a paternal age effect has rarely been considered. We carried out review of the literature to investigate the effect of paternal age on the risks of infecundity and miscarriage. METHODS: We carried out a MEDLINE search and checked the exhaustiveness of our reference list. RESULTS: We identified 19 articles analysing the effect of paternal age. Epidemiological studies provided evidence that paternal age older than 35-40 years affects infecundity. However, the few studies based on data from assisted reproductive techniques (especially IVF with ovum donation) do not confirm this finding. All studies analysing the effect of paternal age on the risk of miscarriage showed an increased risk in men aged 35-40 years or over. Other studies have shown some evidence for a paternal age effect on late foetal deaths. CONCLUSION: The risks of infecundity and miscarriage increase with paternal age. Two main hypotheses can be considered. First, these risks increase after the age of 35-40 years. However, a later paternal age effect (after 45-50 years) cannot be excluded. Second, due to the interaction of the ages of the two partners, the risks of infecundity and miscarriage may be higher when both partners are older (woman aged 35 years or over and man aged 40 years or over).

Abortion, Spontaneous↗
PubMed2001

Risk factors for intrauterine device failure: a review.

After reviewing the literature on intrauterine devices (IUDs) published over the last 30 years, we selected and analyzed recent and most relevant (with appropriate methodology design) articles dealing with the risk factors for IUD failure. There is sufficient evidence to conclude that the TCu380 and levonorgestrel-releasing (LNG) IUD are the most effective, with a cumulative pregnancy rate of less than 2% at 12 years for the TCu380 and around 1% for the LNG IUD at 7 years. In addition, advancing age increases IUD effectiveness, and displacement of the IUD decreases effectiveness. The IUDs with the highest copper concentrations are clearly less prone to failure than those with lower copper concentrations.

Contraception↗
PubMed2000

Increase in scrotal temperature in car drivers.

Several recent studies have reported a gradual decline in sperm production in men. Endocrine disrupters as well as lifestyle have been suggested as risk factors. One lifestyle factor that may affect human fertility is driving a vehicle for a prolonged period. Several authors have suggested that driving position may increase the scrotal temperature. In order to validate this hypothesis we conducted continuous monitoring of scrotal temperature in real conditions, i.e. in men driving a car for a prolonged period. Nine volunteer men were asked to walk outside for 40 min and then to drive a car for 160 min. Scrotal temperatures were measured from thermocouples and values recorded every 2 min on a portable data recorder. Scrotal temperature increased significantly (P < 0.0001) in driving posture after 2 h of driving, reaching a value 1.7-2.2 degrees C higher than that recorded while walking. This link between driving position and increased scrotal temperature indicates a potential exposure of male reproductive function to lifestyle factors.

Adult↗
PubMed1999

Effects of pesticide exposure on time to pregnancy: results of a multicenter study in France and Denmark. ASCLEPIOS Study Group.

The aim of this study was to determine whether there was a relation between male exposure to pesticides and the amount of time needed to conceive (time to pregnancy) for farmers and agricultural workers in France and Denmark. The authors used retrospective studies to compare the time to pregnancy of couples in which the man was exposed to pesticides during the year before the birth of their youngest child with that of couples in which the man was not exposed. In 1995 and 1996, the authors studied 362 French rural workers (142 exposed to pesticides and 220 not exposed), 449 Danish farmers (326 conventional farmers exposed to pesticides and 123 nonexposed organic farmers), and 121 Danish greenhouse workers exposed to pesticides. The fecundability ratio for exposure to pesticides (Cox model, before and after adjustment for confounding factors) did not differ from 1 in any of the three populations. In France, the adjusted fecundability ratio was 1.17 (95% confidence interval (CI) 0.89-1.55) for exposed and nonexposed agricultural workers. In Denmark, it was 1.09 (95% CI 0.82-1.43) for exposed and nonexposed farmers and 0.83 (95% CI 0.69-1.18) for greenhouse workers and nonexposed farmers. Thus, this study found no relation between fertility (time to pregnancy) and male exposure to pesticides.

Adult↗
PubMed1999

Abortion complications in Abidjan (Ivory Coast).

The aim of this study was to describe the various methods of abortion used by women admitted to an obstetrics department in Abidjan (Ivory Coast) for abortion complications. The study was retrospective, and was based on the medical files of all 472 women admitted for abortion complications during a 3-year period (1993-1995). The introduction of plant stems into the uterus, the use of certain instruments, use of vaginal preparations, and ingestion of plants were the most common abortion methods. Seventeen maternal deaths were registered, giving a maternal mortality rate of 3.6%. A high number of previous pregnancies and the ingestion of plants to provoke abortion were factors associated with the highest risk for maternal death. Complications of "local" abortion methods accounted for a high proportion of maternal deaths.

Abortion, Illegal↗
PubMed1999

Objectives, designs and populations of the European Asclepios study on occupational hazards to male reproductive capability.

The main objective of the Asclepios program was to examine occupational risk factors for the male reproductive system. The program focused on occupational exposure to fungicides (farmers, greenhouse workers, and vineyard workers), styrene (laminators in the reinforced plastics industry) and inorganic lead (battery workers, foundry workers, and lead smelters). Questionnaire studies of time to pregnancy were combined with longitudinal and cross-sectional studies of semen quality. The 8 data-collecting centers addressed 6553 male workers and contributed time-to-pregnancy values on the 3077 most recent pregnancies. Data collection was by interview or self-collection. The average response rate across all exposures and centers was 69.8%. The Asclepios project is the first international multicenter research project on environmental risks to male reproductive function. A protocol for epidemiologic research on occupational risk factors to the male reproductive system was developed, and links between epidemiologic and experimental units were established. The majority, but not all, of the studies was completed within the given time frame.

Adult↗
PubMed1998

Prevalence and determinants of current contraceptive method use in a palm oil company in Cameroon.

The principal reasons given by African women for not using contraception include their lack of economic power and control over their choice of partner. An epidemiologic descriptive survey of a cross-section of the female personnel of a Cameroonian palm oil company (SOCAPALM) was carried out in August 1995, to evaluate the various determinants and level of use of various family planning methods in a well defined population of women in employment. An exhaustive list of all the households in the five villages of SOCAPALM was compiled and all women between 15 and 49 years of age who had lived on the palm oil plantation for at least a year were interviewed. The adjusted odds ratios showed that use of modern contraceptive methods was significantly associated with the woman having received secondary education, having more than three children, being the head of the household and, in cases where there was a man regularly present in the household, his approval of family planning. Recently receiving information (during the last month) about family planning was not identified by multivariate analysis as a significant factor affecting the decision to use modern or traditional contraception. The same factors were found to be associated with the use of traditional methods of contraception, but having had an illegal abortion was also associated with the use of such methods. Thus, the level of knowledge about family planning and the prevalence of contraceptive use was significantly higher for women living in industrial environments (such as SOCAPALM), than in the overall population of women in Cameroon. The economic power of the woman, the presence of a strong social reproductive health network, and the positive attitude of men and community leaders were the most important factors affecting the family planning decision of the women.

Abortion, Illegal↗
PubMed1998

Trends and causes of maternal mortality in Kazakhstan.

OBJECTIVE: The aim of this study was to determine trends in the rate and causes of maternal mortality in Kazakhstan. METHODS: Maternal deaths occurring between 1960 and 1996 in the 19 oblast (administrative regions) of Kazakhstan were documented and analyzed. RESULTS: After an initial phase of decrease in the period 1960-1980, the level of maternal mortality in Kazakhstan has been stable at 70-80 maternal deaths per 100,000 live births. Maternal deaths due to hypertension and abortion complications have not substantially decreased. Over the last 10 years, illegal abortions have accounted for most Kazakh maternal deaths resulting from abortion complications. CONCLUSION: To reduce the maternal death rate, the Kazakh health authorities and health workers (obstetricians, midwives, health educators) must develop and rapidly implement maternal health and family planning policies.

Abortion, Illegal↗
PubMed1998

Complications of abortion performed under local anesthesia.

OBJECTIVE: To assess the incidence of complications of abortion performed under local anesthesia. DESIGN: Prospective study. SETTING: A family planning center in the Paris area. POPULATION: Eight hundred and fifty-eight women admitted for abortion under local anesthesia. MAIN OUTCOME MEASURES: Incidence of immediate (the day of vacuum aspiration) and delayed complications (at the follow-up visit 2 weeks after the procedure). RESULTS: Among the 858 women who underwent vacuum aspiration, 683 (80%) attended the follow-up visit 2 weeks after the procedure. Fifty-nine percent of the 858 women had not had a previous abortion, 25% had had one, and 16% had had two or more. The average duration of amenorrhea was 8.6 weeks (19% at 6 or 7 weeks, 67% between 8 and 10 weeks, and 14% after 10 weeks). The overall complication rate was 3.4% (23/683) (95% CI=2.0-4.8%). The incidence of immediate complications was 1.7% (15/858) (0.8-2.6%) and that of delayed complications 1.2% (8/683) (0.4-2.0%). CONCLUSION: This study confirms the safety and efficacy of abortion by vacuum aspiration under local anesthesia.

Abortion, Incomplete↗
PubMed1998

Occupational heat exposure and male fertility: a review.

In humans, as in most mammals, spermatogenesis is temperature dependent. This temperature dependence has been clearly demonstrated by several experimental studies showing that artificial increases in scrotum or testicle temperature in fertile men reduce both sperm output and quality. Our knowledge of the effects of occupational heat exposure on male fertility comes mostly from a small number of epidemiological studies. We conducted an extensive review of these published reports, focusing on methodology and design (retrospective or prospective; reference group; number of subjects) and principal results (using several indicators such as the time taken to obtain a pregnancy or sperm characteristics). We concluded that occupational heat exposure is a significant risk factor for male infertility, affecting sperm morphology and resulting in delayed conception. The limits and biases involved in this type of research are also discussed.

Animals↗
PubMed1998

[Obstetric complications of the first trimester in Western Africa].

The obstetrical complications affecting women in Benin, Senegal and Ivory Coast during the first trimester of pregnancy were studied. Information about the 345 women included in the study was collected from registers maintained by the eight participating maternity units. The most frequent complications observed were spontaneous abortions (50% of admissions), complications of induced abortions (34%), and ectopic pregnancy (8%). Overall, the patients appear to have gained rapid access to care: two thirds of the women underwent interventions on the day of admission. Nevertheless, there were three maternal deaths, two of which followed induced abortion complications.

Abortion, Induced↗
PubMed1997

Contraceptive continuation and its determinants in Benin.

To understand better the rates of continuation of different contraceptive methods, a study in 12 family planning centers in Cotonou and Porto Novo, the two largest cities in Benin, was conducted. From January 1 to December 31, 1993, 944 questionnaires completed by new women acceptors of one of three methods of contraception (oral contraceptive, injection, or IUD) were analyzed. For all methods of contraception, the average length of follow-up was 9.5 months. From the start of the analysis, 44.4% (n = 419) of the women were regularly followed, 49.5% (n = 467) were not regularly followed, and 6.1% (n = 58) reported discontinuation of the method. One year after beginning the use of contraception, the cumulative proportion of women at risk of becoming pregnant, for all the methods together, was 42.0% (38.6-45.4%). Age was associated with the probability of abandoning oral contraception (p = 0.01). Three months after the start, the cumulative proportion of drop-out women having chosen oral contraceptive was 37.2% (22.8-51.6%) of the less than 20-year-olds, 19.0% (14.3-23.7%) of the 20- to 30-year-olds, and 23.4% (15.6-31.2%) of the over 30-year-olds. In contrast, drop-out was not associated with age for women using injection (p = 0.96) or the IUD (p = 0.47). Our results indicate a relatively high and rapid rate of discontinuation for modern contraceptive methods, particularly for young women having chosen oral contraceptive. This finding should incite the family planning educators to give more emphasis to the counseling programs, especially during the first three months.

Adolescent↗
PubMed1997

Effect of male occupational heat exposure on time to pregnancy.

The relationship between male occupational heat exposure and the time required to achieve a pregnancy [TTP] was studied in a retrospective survey of 402 fertile couples. The TTP for t he subgroups 'exposure t o heat' (median = 4 .0 months; mean 11.8; SD = 13.3) and 'professional driver >3 h/day' (median = 4.5; mean = 14.4; SD = 28.5) was significantly longer (both p < 0.05) than for the controls (median = 2.8; mean = 7.8; SD = 13.3). Bakers and welders showed comparable results: only 14% of the bakers' partners became pregnant within 3 months (cf. 55% of controls, p < 0.05) and only 29% became pregnant within 6 months (cf. 74% of controls, p < 0.02). This study suggests that occupational exposure to heat is a 'weak' risk factor for male subfertility.

Adult↗