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P Thonneau

Publications and source records attributed to P Thonneau.

At least 37 records · Page 2Linked to original sources
PubMed1996

Shift work and subfecundity: a European multicenter study. European Study Group on Infertility and Subfecundity.

Shift work has been associated with various unfavorable pregnancy outcomes (ie, pregnancy loss, spontaneous abortion, low birth weight, etc). The suggested underlying mechanism is the interference of shift work with the circadian regulation of human metabolism and, in particular, with the temporal pattern of endocrine function. To analyze the effect of shift work on fecundity, the Time of Unprotected Intercourses (TUI) has been measured in couples recruited in the European Studies on Infertility and Subfecundity, which were undertaken in seven European countries. A low (odds ratio < 2.0) but consistent excess risk of subfecundity (TUI > or = 9.4 months) has been observed both in a representative sample of the general population of women in reproductive age and in a sample of pregnant women or women who had just given birth. The excess risk was also consistently evident both in the subsample of the first pregnancies and in the subsample of the most recent pregnancies. Only the exposure of women to shift work seemed to affect a couple's fecundity; men working shift work did not modify the fecundity pattern of their own couples. No specific job title among shift workers concentrated the risk of subfecundity. No association of menstrual disorders with shift work was identified. Even though residual confounding could partly account for the results and the fact that a plausible biological explanation of the claimed effect is still lacking, data from this study are in favor of an association between shift work and prolonged waiting time to pregnancy.

Adult↗
PubMed1995

A comparative analysis of fall in haemoglobin following abortions conducted by mifepristone (600 mg) and vacuum aspiration.

We compared post-abortion metrorrhagia in 185 women who used the mifepristone (600 mg) plus sulprostone (250 micrograms) drug combination and in 196 women who underwent vacuum aspiration. The patients were monitored for a 2 week period, with haemoglobin being measured on the day of the abortion and 2 weeks later. The women who had used the drug combination experienced a mean fall of 0.7 g/dl in haemoglobin (36% lost > 1 g/dl and 8% > 2 g/dl); haemoglobin concentrations remained stable in women who had had vacuum aspiration.

Abortifacient Agents, Steroidal↗
PubMed1994

Analysis of 369 abortions conducted by mifepristone (RU486) associated with sulprostone in a French family planning center.

OBJECTIVE: To investigate the use of oral mifepristone (RU486; Roussel-Uclaf, Paris, France) associated with IM injection of sulprostone (Schering, Lys-Lez-Lannoy, France) for the induction of legal abortion (7 weeks of amenorrhea in France). DESIGN: An uncontrolled observational study. SETTING: A public family planning center in Paris. PATIENTS: Three hundred sixty-nine (369) pregnant women with up to 7 weeks amenorrhea undergoing legal abortion. INTERVENTIONS: Six hundred milligrams (600 mg) of oral mifepristone followed 48 hours later by an IM injection of 250 micrograms of sulprostone. MAIN OUTCOME MEASURES: Frequency of complete abortion and the need for subsequent surgical evacuation, hospitalization, and blood transfusion. Measurement of the beta-hCG concentration before and 14 days after the oral administration of mifepristone. RESULTS: There was complete abortion in 93.2% of the cases. Of the 25 failures, 8 were continued pregnancies, 6 terminated pregnancy but without expulsion of the conceptus, and 11 were placenta retentions. Eight women required short hospitalization, but none needed blood transfusion. Among the 25 failures, 23 had a beta-hCG concentration > 500 IU/mL [sensitivity 92%, specificity 83%]. CONCLUSION: The sequential use of oral mifepristone and IM injection of sulprostone is effective in inducing abortion up to 7 weeks of amenorrhea. Nevertheless the risk of maternal morbidity associated with sulprostone and also the risk of fetal malformations in cases of continued pregnancy indicate that this method should only be used in specialist centers.

Abortion, Induced↗
PubMed1994

[Maternal mortality in Guinea: magnitude and perspectives].

In recent years maternal mortality in developing countries has become a public health priority for international organizations. However, measuring the true magnitude of this problem is the subject of much methodological debate. In less than a century, the rate of maternal mortality in most industrialized countries has decreased one hundred-fold. In contrast, the rate remains very high in most developing countries, particularly in Africa. In this article based on the studies conducted in Guinea we review various operational proposals which may contribute to improving maternal health and reducing maternal morbidity and mortality, with particular reference to the work of the French speaking organization "Santé Maternelle Internationale".

Adolescent↗
PubMed1993

[Epidemiology of male infertility].

The responsibility of the male in the infertility of the couple has been ignored for long time; it is now universally recognized and obliges general practitioners to explore the possibility of male infertility. Clinical and laboratory examinations must be carried out simultaneously, with a systematic search for the major risk factors of male infertility, such as varicocele and history of genital infection or injury to the testis. The practitioner must also investigate the working conditions and the environment of the infertile male in search for occupational risk factors which are frequently overlooked but often have severe consequences.

Environmental Pollution↗
PubMed1993

[Fertility and environment: a new challenge].

Over the last thirty years the method for both investigating and treating fertility have become more sophisticated and powerful. At the same time, the risk factors for infertility have increased substantially, particularly those resulting from the environment. Spermatogenesis can be considered to be a marker for public health as the consequences of exposure to various factors can be determined objectively. The increase in the number of, and exposure to physical (ionising radiation, heat) and chemical (insecticides, pesticides, antimitotic agents) pose significant problems for human fertility. These issues need to be addressed by both epidemiologists and clinicians.

Environmental Exposure↗
PubMed1992

Level and causes of maternal mortality in Guinea (West Africa).

In order to evaluate the level of maternal mortality at Conakry, capital of Guinea (West Africa), a descriptive epidemiological study was made of all maternal deaths occurring between July 1st, 1989 and June 30th, 1990. To ensure that cases of maternal death were recorded as exhaustively as possible, we conducted this study over 1 year in municipal and hospital maternity units, and 3 months in the urban community. One hundred thirty-nine maternal deaths were registered, representing an annual maternal mortality rate of 559/100,000 live births. The main causes of maternal death were abortion, complications linked with hypertension, and postpartum bleeding.

Abortion, Illegal↗
PubMed1992

Risk factors for maternal mortality: results of a case-control study conducted in Conakry (Guinea).

OBJECTIVE: To assess the risk factors of maternal mortality in an urban area of West Africa (Conakry, capital of Guinea). METHOD: A case-control study where 102 maternal deaths were compared with 338 control women who had given birth and survived, during 1 year (from July 1, 1989 to June 30, 1990). RESULT: Of all the socio-demographic variables studied, only a low family income (R = 2.6; 1.1-6.5) was found to be a risk factor for maternal death In the obstetrical part of the survey, neither parity nor the number or location of pre-natal consultations constituted risk factors. However, the presence during pregnancy or delivery of signs of infection (R = 3.7; 1.4-9.8), anemia (R = 2.1; 1.1-4.1), hypertension (R = 19.8; 5.8-67.8) and dystocia (R = 9.0; 3.7-21.5) were found to be the main predictive risk factors of maternal death. The maternal mortality risk was multiplied by 12 if the women had had a cesarean section, and by 4 in the case of complications in the post-partum period. CONCLUSION: To achieve substantial reductions in maternal mortality levels, work must be done on these specific risk factors, and future programs must urgently be concentrated on a higher standard of pre-natal monitoring, obstetrical emergency facilities and training of obstetrical staff.

Adolescent↗
PubMed1992

Risk factors for female and male infertility: results of a case-control study.

In order to evaluate male and female risk factors for infertility in a case-control study, we have compared all couples in a French administrative region consulting for primary or secondary infertility (of more than one year's duration) with couples in which the woman had given birth during the year of the study. For any one couple, a history of varicocele, male genital infections or testis damage multiplies the risk of primary infertility by a factor of 28, 3 and 4 respectively, and previous female infections (salpingitis) multiply the risk by 45. Similarly, a history of ectopic pregnancy, sexually transmitted diseases or salpingitis multiplies the risk of secondary infertility by a factor of 5, 4 and 7 respectively, and a history of varicocele multiplies this risk by 4.

Adult↗
PubMed1992

[Infertility in France: results of a multicenter survey in three French departments (1988-1989)].

Results are presented from a survey of 1,686 couples living in three French departments who consulted a practitioner over a 12-month period for primary or secondary infertility. "The prevalence rate of infertility was found to be 14.1%, indicating that one woman out of seven in France will consult a doctor for an infertility problem during her reproductive life." The main causes of both male and female infertility are analyzed. (SUMMARY IN ENG)

Developed Countries↗
PubMed1991

Prevalence of infertility: international data and problems of measurement.

This paper discusses the various research options open for measuring the prevalence of infertility. National and regional surveys are both population-based studies but with different methodological approaches. National surveys give information on the various parameters of a couple's reproductive life and indicate the main trends concerning infertility. They give an approximate estimate of the prevalence of infertility, depending on the validity of the collected data. Regional studies can measure the prevalence, incidence, causes and distribution of primary and secondary infertility. When properly carried out, i.e., when the census of infertile couples can be considered as almost exhaustive and when the population studied is representative of the general population, their results can then be inferred on a national scale. Epidemiologists working in infertility have a duty to design appropriate methodologies, thus making public health policymakers aware of the aspects and implications of different types of infertility surveys.

Adolescent↗
PubMed1991

Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988-1989).

To estimate the prevalence and main causes of infertility, a multicentre survey was conducted over 1 year (July 1988-June 1989) in three regions of France. All the 1686 couples in these regions, who consulted a practitioner for primary or secondary infertility during this period, were included in the investigation. The prevalence rate of infertility was found to be 14.1%, indicating that one woman out of seven in France will consult a doctor for an infertility problem during her reproductive life. The main causes of female infertility were ovulation disorders (32%) and tubal damage (26%), and of male infertility oligo-terato-asthenozoospermia (21%), asthenozoospermia (17%), teratozoospermia (10%) and azoospermia (9%). Infertility was also found to be caused by disorders in both the male and female partners together; thus in 39% of cases both the man and woman presented with disorders. The woman alone was responsible for infertility in one-third of cases and the man alone in one-fifth. Unexplained infertility was found in 8% of the couples surveyed.

Adult↗
PubMed1991

Evaluation by women consulting in a family planning centre of their risk of HIV infection.

In order to assess women's self-perception of their risk of infection by HIV, research was performed among 654 women who had consulted in a family planning centre in the Paris region. Of the 452 (69%) women who took part in this research, 77% considered themselves as 'not at risk of carrying the AIDS virus', 11% as 'at risk' and 12% did not give a specific answer. The most important risk factors noted by the patient and the doctor were found to be the number of partners, the use of syringes and the non- or faulty use of condoms. Estimates of the risk of infection by physicians had a high correlation with those of the women, although there were wide differences between the opinions of the six doctors involved. In one case out of three the doctors were unable to decide whether or not their patient was at risk. The evident difficulties experienced by these physicians show an urgent need for the development of specific medical training programmes. The seroprevalence of 2.4% of HIV infection among the women studied, and 1.1% of those who consulted during the study period, confirm the importance of carrying out specific studies on women consulting in family planning centres.

Adult↗
PubMed1991

[Difficulties in conceiving. Discussion about methodology concerning the INED-INSERM survey carried out in France in 1988 on 3,181 women aged between 18 and 49].

Different types of enquiries can be carried out in the field of infertility: descriptive ones (to find out the "frequency" of difficulties in conceiving and their causes) or analytical ones (to show and quantify the risk factors). A descriptive one was conducted on a representative national sample of women ages 18 and 49 years by INED and INSERM in 1988. The results shown here deal with the proportions of women who had had difficulties in conceiving as well as those who had consulted doctors for this reason. One notes that 27% of the women who were questioned had had difficulties and of those who had been waiting for more than one year, 62% had consulted a doctor. On the other hand, from the knowledge that has been gained from this enquiry, some methodological points are discussed, as far as the precise definition of infertility, the sample on which the study is carried out as well as the measured variable (prevalence, annual incidence and cumulative incidence). A particular reference is made to another enquiry carried out on patients who consulted because of infertility in three departments of France in 1988-89.

Adolescent↗
PubMed1990

Does vasectomy have long-term effects on somatic and psychological health status?

All the major international articles on the somatic and psychological consequences of vasectomy published over the last 10 years have been reviewed and analysed. Although some experiments on animals have revealed harmful effects, none of the large-scale epidemiological studies has pointed to any increase in health risks (cardiovascular, hypertensive, psychiatric) in vasectomized men. The contradictions which arise between the clinical and large-scale epidemiological studies may be the result of methodological or experimental conditions. As our knowledge stands at present it can therefore be considered that vasectomy has no major effects on the physical or mental health of men.

Animals↗