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Arch Dis Child Fetal Neonatal Ed. 2010 May;95(3):F188-93. doi: 10.1136/adc.2008.156745. Epub 2009 Apr 23.

Changes in care and outcome of very preterm babies in the Parisian region between 1998 and 2003.

Author information

1
INSERM U953, Hôpital Saint Vincent de Paul, 82 av. Denfert Rochereau, Paris. jennifer.zeitlin@inserm.fr

Abstract

OBJECTIVE:

To assess evolution in the care and health of very preterm babies between 1998 and 2003 after implementation of a regionalisation policy in France.

DESIGN:

Comparison of two population-based cohorts.

SETTING:

The Parisian region.

PATIENTS:

All live births at 24-31 weeks of gestation in 1997 (EPIPAGE study, n=488) and in 2003 (MOSAIC study, n=580). Interventions Implementation of regionalised perinatal networks. Main outcome measures In-hospital mortality and morbidity, including intraventricular haemorrhage (IVH) grade III and IV, cystic periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD).

RESULTS:

Over this period, babies born in level III units rose from 67% to 77% and use of antenatal corticosteroids, indicated deliveries and surfactant increased. In-hospital mortality and IVH grades III/IV declined, ORs of 0.66 (95% CI 0.46 to 0.95) and 0.27 (95% CI 0.15 to 0.47), respectively, while PVL and BPD stayed constant. The rate of very preterm babies discharged alive per 1000 total births increased by 18%, but declined for babies with severe brain lesions.

CONCLUSIONS:

The authors found improvements in mortality and morbidity for very preterm babies and changes in their care over a 6-year period following reinforcement of regionalisation policies.

Comment in

PMID:
19395393
DOI:
10.1136/adc.2008.156745
[Indexed for MEDLINE]

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