0000000000040235
AUTHOR
Cyril Ferdynus
Neonatal problems of late and moderate preterm infants.
International audience; Late and moderate preterm infants account for \textgreater80% of premature births. These newborns experience considerable mortality and morbidity in comparison with full-term born infants. The purpose of this paper is to summarise the most common morbidities of late and moderate preterm infants in the neonatal period, their incidence, severity, risk factors and need for admission to the different levels of care. The recent findings on preventive strategies and management priorities for clinical care of these vulnerable babies are also reviewed.
Éducation thérapeutique structurée par les pairs éducateurs dans le diabète de type 2 au Mali
International audience; Les pays en développement sont confrontés à des ressources financières et humaines limitées, malgré les besoins importants et les défis de santé multiples. Plus de 75% des personnes atteintes de diabète dans le monde vivent dans des pays en développement. En Afrique, le nombre de personnes atteintes de diabète devrait doubler dans les 30 prochaines années.Les défis à relever pour offrir une éducation visant à permettre aux personnes souffrant d'une condition chronique de la gérer eux-mêmes se situent à trois niveaux : les patients, les prestataires de soins, et les systèmes de santé.Au Mali, après le développement de capacités de prise en charge des patients diabétiq…
Pediatric intensive care admissions for respiratory syncytial virus bronchiolitis in France: results of e retrospective survey and evaluation of the validity of a medical information system programme
International audience
Accuracy of blood transfusion in postpartum hemorrhage to assess maternal morbidity.
International audience; OBJECTIVE: To measure the accuracy of blood transfusion (timing and number of blood units) in postpartum hemorrhage (PPH) in a perinatal network. STUDY DESIGN: (1) The ANONYMAT software system was used for anonymization and linkage of two large stand-alone databases, the Burgundy Perinatal Network (BPN) and the National Blood Centre (EFS) databases, which contain, respectively, clinical data from hospital discharges and information concerning any blood transfusion in France (considered as the gold standard database for identifying any transfusion). (2) Identification of prescriptions of at least one red blood cell (RBC) unit at the day of delivery (≥22 weeks) and up …
Impact des variations de distribution de l’âge maternel sur la prévalence attendue à la naissance de la trisomie 21 en France métropolitaine entre 1965 et 2008
Resume Objectifs Evaluer l’impact des facteurs demographiques tels que l’âge des meres sur la prevalence attendue de la trisomie 21 a la naissance. Patients et methodes Nous avons utilise les donnees demographiques nationales francaises colligees par l’Insee portant sur les naissances vivantes ainsi que sur l’âge des meres. La prevalence attendue a la naissance est calculee a partir d’un modele mathematique de regression logistique largement utilise dans le depistage serique de la trisomie 21 fœtale par le dosage des marqueurs seriques maternels. Resultats Nous presentons des donnees continues de prevalence attendue a la naissance sur une large periode qui s’etend de 1965 a 2008. Durant les…
Advantages and limitations of using national administrative data on obstetric blood transfusions to estimate the frequency of obstetric hemorrhages
International audience; BACKGROUND: Obstetric hemorrhages are a frequent cause of maternal death all over the world, but are not routinely monitored. Health systems administrative databases could be used for this purpose, but data quality needs to be assessed. OBJECTIVES: Using blood transfusion data recorded in administrative databases to estimate the frequency of obstetric hemorrhages. Research design A population-based study. Subjects Validation sub-sample: all mothers who gave birth in a French region in 2006-07 (35 123 pregnancies). Main study: all mothers who gave birth in France in 2006-07 (1 629 537 pregnancies). METHOD: Linkage and comparison of administrative data on blood transfu…
Similarly increased congenital anomaly rates after intrauterine insemination and IVF technologies: a retrospective cohort study
International audience; BACKGROUND: While intrauterine insemination (IUI), a simple, inexpensive and non-invasive technique, is the most used assisted reproduction technology (ART) worldwide, the risk of major birth defects following IUI is paradoxically not well documented. METHODS: Retrospective cohort study performed in Burgundy, France, over a 9-year period which consisted of the cross analysis of two prospective databases, the Burgundy perinatal network database and the database of the assisted conception units in Burgundy. A total of 1348 ART singletons [in vitro fertilization technologies (IVFT): n= 903; IUI: n= 445] matched with 4044 infants conceived naturally, 552 ART twins (IVFT:…
Paediatric intensive care admissions for respiratory syncytial virus bronchiolitis in France: results of a retrospective survey and evaluation of the validity of a medical information system programme
SUMMARYThe purpose of this study was to describe the characteristics of patients with bronchiolitis admitted to a paediatric intensive care unit (PICU), and to evaluate a national registry of hospitalizations (Programme de Médicalisation des Systèmes d'Information; PMSI) as a potential source of epidemiological data. Of the 49 French PICUs invited to take part in a retrospective survey of children aged <2 years who were hospitalized during the 2005–2006 epidemic season, 24 agreed to participate. Overall, 467 children were enrolled: 75% were aged <2 months, 76% had positive respiratory syncytial virus (RSV) tests, 34·9% required non-invasive ventilation, 36·6% were mechanically ventila…
Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
International audience; OBJECTIVE: We aimed to investigate the relationship between day-1 hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available. RESULT: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level \textless40 g l(-1)) on day 1 of life occurred in 19.5 % of all patients. The …
Successful control of a Methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit: a retrospective, before-after study
International audience; Background : Aim of this study was to provide a detailed description of a Methicillin-resistant Staphylococcus aureus (MRSA) outbreak management strategy in the neonatal intensive care unit of a university hospital.MethodsThis was a retrospective, “before-after” study, over two consecutive 18-month periods. The outbreak management strategy was performed by a multidisciplinary team and included: extensive healthcare workers (HCW) involvement, education, continuous hand-hygiene training and active MRSA colonization surveillance. The actions implemented were identified based on an anonymous, voluntary, reporting system, carried out among all the HCW, and regular audit a…
Variations de prévalence de la trisomie 21 en population française entre 1978 et 2005
Resume Objectifs Evaluer l’impact de l’augmentation de l’âge des meres et du diagnostic prenatal sur la prevalence de la trisomie 21 dans un echantillon de la population francaise. Patients et methodes Les donnees sur la trisomie 21 ont ete obtenues a partir du registre de malformations congenitales REMERA entre 1978 et 2005. La population surveillee correspond a environ 10 % des naissances francaises. Nous avons etudie la prevalence totale, la prevalence des naissances vivantes ainsi que la prevalence des interruptions de grossesse apres diagnostic prenatal positif. Resultats L’âge moyen des meres a augmente passant de 26 a 30 ans sur la duree de l’etude. La prevalence totale de la trisomi…
Reference Ranges and Distribution of Placental Volume by 3-Dimensional Virtual Organ Computer-Aided Analysis Between 11 Weeks and 13 Weeks 6 Days
OBJECTIVES The purpose of this study was to determine the feasibility, reproducibility, and distribution of placental volume measurements according to the crown-rump length between 11 weeks and 13 weeks 6 days. METHODS Images were acquired in 128 pregnancies followed in Burgundy during first-trimester screening sonography using an abdominal 3-dimensional transducer. The placental volume was then calculated by the virtual organ computer-aided analysis method with a rotation angle of 30° by a single operator. RESULTS Placental volumes ranged from 33.3 to 107.6 cm(3) with a mean ± SD of 62.3 ± 14.8 cm(3); the 5th and 10th percentiles were 38.0 and 44.20 cm(3), respectively, whereas the 90th an…
Using Discharge Abstracts to Evaluate a Regional Perinatal Network: Assessment of the Linkage Procedure of Anonymous Data
To assess the Burgundy perinatal network (18 obstetrical units; 18 500 births per year), discharge abstracts and additional data were collected for all mothers and newborns. In accordance with French law, data were rendered anonymous before statistical analysis, and were linked to patients using a specific procedure. This procedure allowed data concerning each mother to be linked to those for her newborn(s). This study showed that all mothers and newborns were included in the regional database; the data for all mothers were linked to those for their infant(s) in all cases. Additional data (gestational age) were obtained for 99.9% of newborns.
Very preterm birth: who has access to antenatal corticosteroid therapy?
International audience; We describe the administration of antenatal corticosteroid therapy (ACT) for liveborn very preterm neonates in a population-based study. A total of 790 very preterm neonates (between 24 and 31 full weeks of gestation) were included in this regionally defined population of very preterm neonates in France. The main outcome measure was non-access to ACT. Data were analysed using logistic and polytomous models to control for neonatal and sociodemographic characteristics, mechanisms of very preterm birth and neonatal network organisation. As compared with level III, births in levels I-II maternity units were closely related to non-access to ACT (60.1% vs. 8.8%), but not t…
Comparison of the ability of alternative birthweight and fetal weight standards to identify preterm newborns at increased risk of perinatal death
Objective To compare prediction of perinatal deaths among preterm infants based on fetal weight standards versus a new subpopulation-based birthweight standard. Design Population-based cohort study. Setting France. Population A total of 9100 preterm singletons, born between 24 and 36 weeks of gestation in 2000–09, in Burgundy (France). Methods We first classified all newborns as either small for gestational age (SGA) or not, based on alternative fetal weight or birthweight standards, including a new birthweight standard that excludes infants born to mothers with disease related to the weight of a fetus. Based on discrepancies between the different classifications, we then divided the newbor…