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.
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.
Authors: N Marlow; C Bennett; E S Draper; E M Hennessy; A S Morgan; K L Costeloe Journal: Arch Dis Child Fetal Neonatal Ed Date: 2014-03-06 Impact factor: 5.747
Authors: Amir-Mohammad Armanian; Zohreh Badiee; Raha Afghari; Nima Salehimehr; Akbar Hassanzade; Soghra Sheikhzadeh; Maryam Shariftehrani; Gohar Rezvan Journal: Int J Prev Med Date: 2014-05