Changes in care and outcome of very preterm babies in the Parisian region between 1998 and 2003. Issue 3 (23rd April 2009)

• Record Type: Journal Article
• Authors: Zeitlin, Jennifer; Ancel, Pierre-Yves; Delmas, Dominique; Bréart, Gérard; Papiernik, Emile
• Is Part Of: Archives of disease in childhood. Volume 95:Issue 3(2010)
• Page Start: F188
• Page End: F193
• Publication Date: 2009-04-23
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/adc.2008.156745
• Languages: English
• ISSNs: 1359-2998

Abstract

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.