In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn : Contribution from a French nationwide study
© 2023 International Federation of Gynecology and Obstetrics..
OBJECTIVE: To investigate maternal and neonatal outcomes after a delivery in France in 2019, according to hospital characteristics and the impact of distance and time of travel on mother and newborn.
METHODS: All parturients above 18 years of age who delivered in 2019 and were identified in the French health insurance database were included, with their newborns, in this retrospective cohort study. Main outcome measures were Severe Maternal Morbidity score and the Neonatal Adverse Outcome Indicator (NAOI).
RESULTS: Among the 733 052 pregnancies included, 10 829 presented a severe maternal morbidity (1.48%) and 77 237 had a neonatal adverse outcome (10.4%). Factors associated with an unfavorable maternal or neonatal outcome were Obstetric Comorbidity Index, primiparity, and cesarean or instrumental delivery. Prematurity was associated with less severe maternal morbidity but more neonatal adverse outcomes. Time of travel above 30 min was associated with a higher NAOI rate.
CONCLUSIONS: Results suggest the efficiency of regionalization of perinatal care in France, although a difference in both outcomes persists according to unit volume, suggesting the need for a further step in concentrating perinatal care. Perinatal care organization should focus on mapping the territory with high-level, high-volume maternity throughout the territory; this suggests closing down high-volume units and improving low-volume ones to maintain coherent mapping.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:164 |
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| Enthalten in: |
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics - 164(2023), 1 vom: 24. Jan., Seite 210-218 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Levaillant, Mathieu [VerfasserIn] |
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| Links: |
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| Themen: |
Data reuse |
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| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 16.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ijgo.15004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359859402 |
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| 245 | 1 | 0 | |a In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn |b Contribution from a French nationwide study |
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| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 16.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 International Federation of Gynecology and Obstetrics. | ||
| 520 | |a OBJECTIVE: To investigate maternal and neonatal outcomes after a delivery in France in 2019, according to hospital characteristics and the impact of distance and time of travel on mother and newborn | ||
| 520 | |a METHODS: All parturients above 18 years of age who delivered in 2019 and were identified in the French health insurance database were included, with their newborns, in this retrospective cohort study. Main outcome measures were Severe Maternal Morbidity score and the Neonatal Adverse Outcome Indicator (NAOI) | ||
| 520 | |a RESULTS: Among the 733 052 pregnancies included, 10 829 presented a severe maternal morbidity (1.48%) and 77 237 had a neonatal adverse outcome (10.4%). Factors associated with an unfavorable maternal or neonatal outcome were Obstetric Comorbidity Index, primiparity, and cesarean or instrumental delivery. Prematurity was associated with less severe maternal morbidity but more neonatal adverse outcomes. Time of travel above 30 min was associated with a higher NAOI rate | ||
| 520 | |a CONCLUSIONS: Results suggest the efficiency of regionalization of perinatal care in France, although a difference in both outcomes persists according to unit volume, suggesting the need for a further step in concentrating perinatal care. Perinatal care organization should focus on mapping the territory with high-level, high-volume maternity throughout the territory; this suggests closing down high-volume units and improving low-volume ones to maintain coherent mapping | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a delivery | |
| 650 | 4 | |a maternity level | |
| 650 | 4 | |a perinatal facility mapping | |
| 650 | 4 | |a regionalization | |
| 700 | 1 | |a Garabédian, Charles |e verfasserin |4 aut | |
| 700 | 1 | |a Legendre, Guillaume |e verfasserin |4 aut | |
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| 700 | 1 | |a Hamel, Jean-François |e verfasserin |4 aut | |
| 700 | 1 | |a Vallet, Benoît |e verfasserin |4 aut | |
| 700 | 1 | |a Lamer, Antoine |e verfasserin |4 aut | |
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