https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01024-7.pdf

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60820-4.pdf

National regional and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications.

Hyperglycemia and Adverse Pregnancy Outcomes

Resumen Incidencia mundial de parto prematuro: revision sistematica de la morbilidad y mortalidad maternas Objetivo Analizar las tasas de prematuridad a nivel mundial para evaluar la incidencia de este problema de salud publica, determinar la distribucion regional de los partos prematuros y profundizar en el conocimiento de las actuales estrategias de evaluacion.Metodos Los datos utilizados sobre las tasas de prematuridad a nivel mundial se extrajeron a lo largo de una revision sistematica anterior de datos publicados e ineditos sobre la mortalidad y morbilidad maternas notificados entre 1997 y 2002. Esos datos se complementaron mediante una busqueda que abarco el periodo 2003–2007. Las tasas de prematuridad de los paises sin datos se estimaron mediante modelos de regresion multiple especificos para cada region.Resultados Estimamos que en 2005 se registraron 12,9 millones de partos prematuros, lo que representa el 9,6% de todos los nacimientos a nivel mundial. Aproximadamente 11 millones (85%) de ellos se concentraron en Africa y Asia, mientras que en Europa y America del Norte (excluido Mexico) se registraron 0,5 millones en cada caso, y en America Latina y el Caribe, 0,9 millones. Las tasas mas elevadas de prematuridad se dieron en Africa y America del Norte (11,9% y 10,6% de todos los nacimientos, respectivamente), y las mas bajas en Europa (6,2%).Conclusion El parto prematuro es un problema de salud perinatal importante en todo el mundo. Los paises en desarrollo, especialmente de Africa y Asia meridional, son los que sufren la carga mas alta en terminos absolutos, pero en America del Norte tambien se observa una tasa elevada. Es necesario comprender mejor las causas de la prematuridad y obtener estimaciones mas precisas de la incidencia de ese problema en cada pais si se desea mejorar el acceso a una atencion obstetrica y neonatal eficaz.

/pdf/the-worldwide-incidence-of-preterm-birth-a-systematic-review-210c5n0761.pdf

The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity

The aim of this study was to revise the 2003 Fenton Preterm Growth Chart, specifically to: a) harmonize the preterm growth chart with the new World Health Organization (WHO) Growth Standard, b) smooth the data between the preterm and WHO estimates, informed by the Preterm Multicentre Growth (PreM Growth) study while maintaining data integrity from 22 to 36 and at 50 weeks, and to c) re-scale the chart x-axis to actual age (rather than completed weeks) to support growth monitoring. Systematic review, meta-analysis, and growth chart development. We systematically searched published and unpublished literature to find population-based preterm size at birth measurement (weight, length, and/or head circumference) references, from developed countries with: Corrected gestational ages through infant assessment and/or statistical correction; Data percentiles as low as 24 weeks gestational age or lower; Sample with greater than 500 infants less than 30 weeks. Growth curves for males and females were produced using cubic splines to 50 weeks post menstrual age. LMS parameters (skew, median, and standard deviation) were calculated. Six large population-based surveys of size at preterm birth representing 3,986,456 births (34,639 births < 30 weeks) from countries Germany, United States, Italy, Australia, Scotland, and Canada were combined in meta-analyses. Smooth growth chart curves were developed, while ensuring close agreement with the data between 24 and 36 weeks and at 50 weeks. The revised sex-specific actual-age growth charts are based on the recommended growth goal for preterm infants, the fetus, followed by the term infant. These preterm growth charts, with the disjunction between these datasets smoothing informed by the international PreM Growth study, may support an improved transition of preterm infant growth monitoring to the WHO growth charts.

/pdf/a-systematic-review-and-meta-analysis-to-revise-the-fenton-1bkcp7xdca.pdf

A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants

La mortalite perinatale est un indicateur demographique souvent employe pour evaluer la qualite des soins medicaux. Son utilisation necessite certaines precautions car cet indicateur peut etre influence par les regles d'enregistrement des naissances et des deces a l'etat-civil et par le respect plus ou moins grand de ces regles. C'est pour eviter les risques de confusion entre les vrais et les faux mort-nes (enfants nes vivants et decedes avant la declaration de leur naissance a l'etat-civil) que la naissance et le deces sont enregistres separement depuis 1993. Il s'avere que la modification des regles d'enregistrement n'a pas produit de rupture importante dans l'evolution des taux. L'A. detaille les differentes hypotheses correspondant a l'evolution des criteres d'enregistrement comme a celle de prise en charge des grands prematures

La modification des règles d'enregistrement des naissances vivantes et des mort-nés en France. Quel impact sur la mortalité périnatale?

Registration of births of very low birthweight infants

Introduction While use of augmentation of labor (AL) is appropriate for labor dystocia, it is frequently used inadequately and unnecessarily The objective was to assess at a national level, the frequency and determinants of misuse of augmentation of labor (AL) Material and methods Women of the French perinatal survey of 2016 with a singleton cephalic fetus, delivering at term after a spontaneous labor were included “Misuse of AL” was defined by artificial rupture of the membranes (ROM) and/or oxytocin within one hour of admission and/or duration between ROM and oxytocin of less than one hour Women, labor and maternity unit’s characteristics were compared between the “misuse of AL” and “no misuse of AL” groups by bivariate analysis To identify the determinants of misuse of AL, a multivariable multilevel logistic regression was performed taking into account the data’s hierarchical structure (first level: women, second level: maternity units) Results Among the 7196 women included, 1524 (212%) had a misuse of AL The determinants of misuse of AL were middle school educational level (reference high school), aOR = 121; 95%CI[101–145], gestational age at delivery ≥41weeks (reference 39–40 weeks), aOR = 119; 95%CI[100–142], cervical dilation ≥6cm at admission (reference <3cm), aOR = 139; 95%CI[110–176], epidural analgesia aOR = 163; 95%CI[135–196], delivery in a private hospital (reference public teaching hospital), aOR = 225; 95%CI[157–323]; and maternity units with <1000 deliveries/year and 1000–1999 deliveries/year (reference ≥3000 deliveries/year), respectively aOR = 152; 95%CI[111–208] and aOR = 142; 95%CI[105–192] Less than 3% of the variance was explained by women characteristics, and 2417% by the maternity units’ characteristics Conclusions In France, one spontaneous laboring woman among five is subject to misuse of AL The misuse is mostly explained by maternity unit’s characteristics The determinants identified in this study can be used to implement targeted actions in small and private maternity units

/pdf/frequency-and-determinants-of-misuse-of-augmentation-of-13pgufbvgm.pdf

Frequency and determinants of misuse of augmentation of labor in France: A population-based study.

En France, l’organisation des services de sante perinatale subit actuellement de profondes mutations en raison de la restructuration de l’offre de soins et notamment en raison de la fermeture des petites ou moyennes maternites Au-dela des polemiques suscitees lors de la suppression d’un etablissement, ces restructurations ont-elles des repercussions sur l’accessibilite aux maternites pour les parturientes ? A la suite des fermetures successives de maternites, notre etude a pour objectif de presenter les recompositions des pratiques spatiales des femmes et de lire les nouvelles aires d’attraction Le territoire d’etude est la region Bourgogne, territoire heterogene, aux forces centrifuges associant des zones urbaines, periurbaines et rurales enclavees Cette etude met en evidence les inegalites spatiales d’acces aux soins et apporte des elements d’analyse face aux questions d’equite que se posent les decideurs et les professionnels de sante publique

/pdf/une-geographie-de-l-offre-de-soins-en-restructuration-les-1f4ohqwhif.pdf

Une géographie de l’offre de soins en restructuration : les territoires des maternités en Bourgogne

In France, while the prevalence of contraception is high, a significant proportion of pregnancies are unintended. Following the 2012 pill scare, the contraceptive method mix, which was mostly comprised of pills and intrauterine devices (IUD), has become more diversified. In this changing landscape, our objective was to describe trends in live births resulting from contraceptive failure and evaluate how patterns of contraceptive use have contributed to observed changes between 2010 and 2016. We used data from the 2010 and the 2016 French National Perinatal surveys which included all births from all maternity units in France over a one-week period. Interviews collecting information about pre-conception contraceptive practices were conducted in the maternity ward post-delivery. Women were classified as having a contraceptive failure if they discontinued contraception because they were pregnant. Our study sample included adult women who had a live birth, had ever used contraception and did not undergo infertility treatment (n = 11,590 in 2010 and n = 9703 in 2016). We evaluated changes in contraceptive failure over time using multivariate Poisson regressions to adjust for sociodemographic characteristics and pre-pregnancy contraceptive methods. Pre-pregnancy contraception evolved between 2010 and 2016 with a 12.3% point-drop in pill use, and conversely, 4.6%- and 3.2%-point increases in IUD and condom use, respectively. Use of other barrier or natural methods doubled between 2010 and 2016 but remained marginal (1.4% in 2010 vs 3.6% in 2016). Between 2010 and 2016, the proportion of live births resulting from contraceptive failure rose from 7.8 to 10.0%, with higher risks among younger, parous and socially disadvantaged mothers. The risk ratio of contraceptive failure in 2016 compared to 2010 remained higher after sociodemographic adjustments (aRR = 1.34; 95% CI; 1.23–1.47) and after adjusting for pre-pregnancy contraceptive method mix (aRR = 1.35; 95% CI; 1.25–1.49). Increases in contraceptive failures were concentrated among pill and condom users. Recent shifts in contraceptive behaviors in France following the 2012 pill scare may be associated with a subsequent increase in births resulting from short acting contraceptives failures.

/pdf/a-rise-in-births-following-contraceptive-failure-in-france-5cwviu1suk.pdf

Béatrice Blondel

Papers

La modification des règles d'enregistrement des naissances vivantes et des mort-nés en France. Quel impact sur la mortalité périnatale?

Registration of births of very low birthweight infants

Frequency and determinants of misuse of augmentation of labor in France: A population-based study.

Une géographie de l’offre de soins en restructuration : les territoires des maternités en Bourgogne

A rise in births following contraceptive failure in France between 2010 and 2016: results from the French national perinatal surveys