title: Maternal obesity and rate of cesarean delivery in Djibouti.
abstract: OBJECTIVE
  To calculate the prevalence of maternal obesity and to determine the relation between obesity and cesarean delivery in an urban hospital in Djibouti.
  
  
  METHODS
  In an observational cohort study, all women who had a live birth or stillbirth between October 2012 and November 2013 were considered for inclusion. Body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was calculated throughout pregnancy, and women with a BMI of at least 30.0 were deemed to be obese. Multivariate logistic regression analyses were used to evaluate the relation between cesarean and obesity.
  
  
  RESULTS
  Overall, 100 (24.8%) of 404 women were obese before 14 weeks of pregnancy, as were 112 (25.2%) of 445 before 22 weeks, and 200 (43.2%) of 463 at delivery. Obesity before 22 weeks was associated with a 127% excess risk of cesarean delivery (adjusted odds ratio 2.27; 95% CI 1.07-4.82; P=0.032). Similar trends were found when the analyses were limited to the subgroup of women without a previous cesarean delivery or primiparae.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti. Electronic address: afminsart@gmail.com.
authors.forename: Anne-Frederique
authors.initials: AF
authors.lastname: Minsart
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti.
authors.forename: Thai-Son
authors.initials: TS
authors.lastname: N'guyen
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti.
authors.forename: Hirut
authors.initials: H
authors.lastname: Dimtsu
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti.
authors.forename: Rachel
authors.initials: R
authors.lastname: Ratsimanresy
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti.
authors.forename: Fouad
authors.initials: F
authors.lastname: Dada
authors.affiliation: Department of Gynecology and Obstetrics, Affi Hospital, Djibouti City, Djibouti.
authors.forename: Rachid
authors.initials: R
authors.lastname: Ali Hadji
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015730:Djibouti / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence
keywords: Body mass index; Cesarean delivery; Maternal obesity