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

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


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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight
  • Bronchopulmonary Dysplasia / epidemiology
  • Delivery of Health Care / organization & administration
  • Delivery of Health Care / trends
  • Female
  • France / epidemiology
  • Gestational Age
  • Hospital Mortality / trends
  • Humans
  • Infant Care / methods
  • Infant Care / organization & administration
  • Infant Care / trends*
  • Infant Mortality / trends
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / epidemiology
  • Infant, Very Low Birth Weight
  • Intracranial Hemorrhages / epidemiology
  • Leukomalacia, Periventricular / epidemiology
  • Male
  • Patient Discharge / statistics & numerical data
  • Treatment Outcome