Objective: To assess evolutions 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 24 to 31 weeks of gestation in 1997 (EPIPAGE study, N=488) and 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 leukomalacia (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 intraventricular haemorrhage grades III/IV declined, ORs of 0.66 (95% CI: 0.46-0.95) and 0.27 (95% CI: 0.15-0.47) respectively, while periventricular leukomalacia and bronchopulmonary dysplasia 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: We 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.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.