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62. Effect of Intra- and Extrauterine Growth on Long-Term Neurologic Outcomes of Very Preterm Infants

Author

Guellec, Isabelle, Lapillonne, Alexandre, Picaud, Jean-Charles, Mitanchez, Delphine, Charkaluk, Marie-Laure, Flamand, Cyril, Roze, Jean-Christophe, Ancel, Pierre-Yves, Larroque, Benoit, Ancel, P.Y., Blondel, B., Bréart, G., Garel, M., Kaminski, Monique, Maillard, F., du Mazaubrun, C., Missy, P., Sehili, F., Supernant, K., Marchand, L., Durand, M., Matis, J., Messer, J., Treisser, A., Burguet, A., Abraham-Lerat, L., Menget, A., Roth, P., Schaal, P., Thiriez, G., Leveque, C., Marret, Stéphane, Marpeau, L., Boulot, P., Cambonie, Gilles, Picaud, C., Donadio, M., Ledésert, B., André, M., Fresson, Jeanne, Hascoët, M., Arnaud, Catherine, Grandjean, H., Rolland, M., Fily, A., Ego, Anne, Outtier, M., Pierrat, V., Subtil, D., Truffert, P., Boog, G., Rouger-Bureau, V., Rozé, C., Dehan, M., Zupan-Simunek, V., Vodovar, M., Voyer, M., Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Trousseau [APHP], Centre hospitalier universitaire de Nantes (CHU Nantes), Département de Périnatologie, Hôpital Mère Enfant, Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Laboratoire des Adaptations Métaboliques à l'Exercice en Conditions Physiologiques et Pathologiques (AME2P), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Faculté des Sciences du SportFaculté des Sciences du Sport, UFR STAPS, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Rouen, Normandie Université (NU), Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Cergy Pontoise (UCP), Université Paris-Seine, Swedish Institute of Space Physics [Uppsala] (IRF), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), DGA Tech. Navales, DGA Tech.Navales, Service de Médecine Néonatale, Hôpital Jeanne de Flandre [Lille], Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Biologie et physiologie des cellules digestives, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche clinique intersectorielle du Centre Hospitalier Henri Laborit, Centre Hospitalier Henri Laborit (CHL), Faculté des Sciences du SportFaculté des Sciences du Sport, UFR STAPS-Université Blaise Pascal - Clermont-Ferrand 2 (UBP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-UFR Sciences et Techniques des Activités Physiques et Sportives - Clermont-Ferrand (UFR STAPS - UBP), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-IMAG-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-IMAG-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), and Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])

Subjects
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2016

63. Novel Approach to Estimate Osteoarthritis Progression: Use of the Reliable Change Index in the Evaluation of Joint Space Loss.

Author

Parsons, Camille M., Judge, Andrew, Leyland, Kirsten, Bruyère, Olivier, Petit Dop, Florence, Chapurlat, Roland, Reginster, Jean‐Yves, Edwards, Mark H., Dennison, Elaine M., Cooper, Cyrus, Inskip, Hazel, Christiansen, C., Delmas, P., Genant, H., Zacher, J., Bellamy, N., Speirs, C., Bréart, G., Meyer, O., and Gensburger, D.

Abstract

Objective: Osteoarthritis-related changes in joint space measurements over time are small and sensitive to measurement error. The Reliable Change Index (RCI) determines whether the magnitude of change observed in an individual can be attributed to true change. This study aimed to examine the RCI as a novel approach to estimating osteoarthritis progression.Methods: Data were from 167 men and 392 women with knee osteoarthritis (diagnosed using the American College of Rheumatology criteria) randomized to the placebo arm of the 3-year Strontium Ranelate Efficacy in Knee Osteoarthritis trial (SEKOIA) and assessed annually. The RCI was used to determine whether the magnitude of change in joint space width (JSW) on radiographs between study years was likely to be true or due to measurement error.Results: Between consecutive years, 57-69% of participants had an apparent decrease (change <0) in JSW, while 31-43% of participants had annual changes indicating improvement in JSW. The RCI identified JSW decreases in only 6.0% of patients between baseline and year 1, and in 4.5% of patients between the remaining study years. The apparent increases in JSW were almost eliminated between baseline and year 1, and between years 1 and 2 only 1.3% of patients had a significant increase, dropping to 0.9% between years 2 and 3.Conclusion: The RCI provides a method to identify change in JSW, removing many apparent changes that are likely to be due to measurement error. This method appears to be useful for assessing change in JSW from radiographs in clinical and research settings. [ABSTRACT FROM AUTHOR]

Published
2019
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64. Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in ten European regions

Author

MS Neonatologie, Marques-Bonet, T., Cuttini, Marina, Piedvache, A., Boyle, Elaine M., Jarreau, Pierre Henri, Kollée, Louis A A, Maier, Rolf F., Milligan, David W A, van Reempts, P., Weber, Tom, Barros, Henrique, Gadzinowki, J., Draper, E. S., Zeitlin, Jennifer, Martens, E., Martens, Guy, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Pryds, Ole, Ancel, Pierre Yves, Blondel, Beatrice, Bréart, G., Gortner, Ludwig, Kuenzel, W., Misselwitz, Bjoern, Schmidt, S., Agostino, Rocco, DiLallo, D., Franco, Francesco, Paesano, R., Hukkelhoven, C., Hulscher, M., Koopman-Esseboom, C., van Heijst, A., Breborowicz, G., Gadzinowski, Janusz, Mazela, Jan, Carrapato, M., Ribeiro-Rodrigues, Teresa, Konje, J., Manktelow, B. N., Fenton, A. C., Sturgiss, S., the MOSAIC and EPICE research groups, MS Neonatologie, Marques-Bonet, T., Cuttini, Marina, Piedvache, A., Boyle, Elaine M., Jarreau, Pierre Henri, Kollée, Louis A A, Maier, Rolf F., Milligan, David W A, van Reempts, P., Weber, Tom, Barros, Henrique, Gadzinowki, J., Draper, E. S., Zeitlin, Jennifer, Martens, E., Martens, Guy, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Pryds, Ole, Ancel, Pierre Yves, Blondel, Beatrice, Bréart, G., Gortner, Ludwig, Kuenzel, W., Misselwitz, Bjoern, Schmidt, S., Agostino, Rocco, DiLallo, D., Franco, Francesco, Paesano, R., Hukkelhoven, C., Hulscher, M., Koopman-Esseboom, C., van Heijst, A., Breborowicz, G., Gadzinowski, Janusz, Mazela, Jan, Carrapato, M., Ribeiro-Rodrigues, Teresa, Konje, J., Manktelow, B. N., Fenton, A. C., Sturgiss, S., and the MOSAIC and EPICE research groups

Published
2017

67. Public health impact of Infanrix hexa™ (DTPa-HBV-IPV/Hib) reimbursement: A study programme in France. Part 2: Evolution of the acceptability of infants’ vaccination against hepatitis B in general and pediatric practices – the PRALINE study

Author

Vié le Sage, F., primary, Gaudelus, J., additional, Lert, F., additional, Dufour, V., additional, Texier, N., additional, Pouriel, M., additional, Schück, S., additional, Tehard, B., additional, and Bréart, G., additional

Published
2016
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69. Post-partum : recommandations pour la pratique clinique – Texte court

Author

Sénat, M.-V., primary, Sentilhes, L., additional, Battut, A., additional, Benhamou, D., additional, Bydlowski, S., additional, Chantry, A., additional, Deffieux, X., additional, Diers, F., additional, Doret, M., additional, Ducroux-Schouwey, C., additional, Fuchs, F., additional, Gascoin, G., additional, Lebot, C., additional, Marcellin, L., additional, Plu-Bureau, G., additional, Raccah-Tebeka, B., additional, Simon, E., additional, Bréart, G., additional, and Marpeau, L., additional

Published
2015
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72. Programme d’étude évaluant l’impact de santé publique du remboursement de la spécialité InfanrixHexa®, en population générale et en médecine générale et pédiatrique. Études pharmaco-épidémiologiques réalisées à la demande des autorités de santé

Author

Leproust, S., primary, Bréart, G., additional, Dufour, V., additional, Gaudelus, J., additional, Lert, F., additional, Vié le Sage, F., additional, and Téhard, B., additional

Published
2014
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73. [Acid base balance in the fetus during labor: pathophysiology and exploration methods]

Author

Uzan S, Berkane N, Verstraete L, Mathieu E, and Bréart G

Subjects
Labor, Obstetric, Scalp, Pregnancy, Humans, Female, Lactic Acid, Acid-Base Imbalance, Heart Rate, Fetal, Hydrogen-Ion Concentration, Fetal Hypoxia, Fetal Monitoring, Maternal-Fetal Exchange, Fetal Distress
Abstract

Although the majority (about 90%) of cerebral palsies are related to antenatal or postnatal causes, search for acute fetal distress during labor remains one of the primary objectives of obstetrical surveillance. Acute fetal distress leads to hypoxemia which induced hypoxia and then asphyxia of most of the organs, including the noble organs such as the brain. Most of the parameters used for fetal monitoring have good sensitivity but low specificity. Furthermore, there is a weak correlation between the different parameters measured and the neonatal status which remains difficult to predict with certainty. The general "philosophy" behind fetal monitoring consists in detecting warning signs and, when warning signs are observed, to measure one or more other parameters to assess the state of hypoxia and its consequences. Fetal heart rate is a warning sign used by all teams. Irrespective of the method used to analyze fetal heart rate when anomalies are detected, metabolic acidosis induced by anoxia is an indispensable element for assessing severity. The development of fetal hypoxia is related to two essential phenomena: anaerobic glycolysis with lactate production and glycogenolysis to meet energy needs. Metabolic acidosis can be measured directly by scalp pH or lactate measurements, or indirectly by measuring its effect on heart conduction as expressed in the ST segment. The underlying physiological mechanisms and the methods used to evaluate acid base balance are described here.

Published
2003

74. [Per-partum anoxia and handicaps: epidemiological aspects]

Author

Goffinet F and Bréart G

Subjects
Asphyxia Neonatorum, Perinatal Care, Cerebral Palsy, Infant, Newborn, Humans
Abstract

Although per-partum anoxia accounts for only a small part (less than 10%) of the etiology of cerebral palsy, statistical computations, based on current epidemiological data, show that, when per-partum anoxia is associated with suboptimal care 9 out of 10 cases of cerebral palsy could be attributed to the anoxia.

Published
2003

75. [Development of the main indicators of perinatal health in metropolitan France between 1995 and 1998. Results of the national perinatal survey]

Author

Blondel B, Norton J, du Mazaubrun C, and Bréart G

Subjects
Adult, Urban Population, Cesarean Section, Infant, Newborn, Pregnancy Outcome, Twins, Gestational Age, Prenatal Care, Delivery, Obstetric, Health Surveys, Perinatal Care, Reproductive Techniques, Pregnancy, Humans, Female, France, Infant, Premature, Maternal Age
Abstract

To study trends in the main indicators of health, medical practice and risk factors.We compared two samples; both included all stillbirths and live births during one week in France: 13,318 in 1995 and 13,718 in 1998.Between 1995 and 1998, there was an increase in maternal age, a development of some characteristics of care (antenatal care by maternity unit staff, HIV screening procedure, antenatal classes) and an increase in the proportion of caesarean sections and epidurals. The proportion of live births before 37 weeks of gestation increased from 5.4% to 6.2%. This trend is explained by an increase in preterm deliveries among twins. Specific questions in the 1998 questionnaire showed that 6.3% of women had received fertility treatment before this pregnancy, 11.1% had an amniocentesis, and 1.1% had an intrauterine transfer.This type of survey carried out every three years can show major changes in health, risk factors and medical practices and can yield quick answers to specific questions.

Published
2002

76. Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates

Author

Prual, A., Bouvier-Colle, M. H., de Bernis, L., and Bréart, G.

Subjects
Adult, Prenatal Care, Pregnancy Complications, Africa, Western, Maternal Mortality, Social Class, Pregnancy, Surveys and Questionnaires, Humans, Female, Prospective Studies, reproductive and urinary physiology, Research Article, Demography
Abstract

Data on maternal morbidity make it possible to assess how many women are likely to need essential obstetric care, and permit the organization, monitoring and evaluation of safe motherhood programmes. In the present paper we propose operational definitions of severe maternal morbidity and report the frequency of such morbidity as revealed in a population-based survey of a cohort of 20,326 pregnant women in six West African countries. The methodology and questionnaires were the same in all areas. Each pregnant woman had four contacts with the obstetric survey team: at inclusion, between 32 and 36 weeks of amenorrhoea, during delivery and 60 days postpartum. Direct obstetric causes of severe morbidity were observed in 1215 women (6.17 cases per 100 live births). This ratio varied significantly between areas, from 3.01% in Bamako to 9.05% in Saint-Louis. The main direct causes of severe maternal morbidity were: haemorrhage (3.05 per 100 live births); obstructed labour (2.05 per 100), 23 cases of which involved uterine rupture (0.12 per 100); hypertensive disorders of pregnancy (0.64 per 100), 38 cases of which involved eclampsia (0.19 per 100); and sepsis (0.09 per 100). Other direct obstetric causes accounted for 12.2% of cases. Case fatality rates were very high for sepsis (33.3%), uterine rupture (30.4%) and eclampsia (18.4%); those for haemorrhage varied from 1.9% for antepartum or peripartum haemorrhage to 3.7% for abruptio placentae. Thus at least 3-9% of pregnant women required essential obstetric care. The high case fatality rates of several complications reflected a poor quality of obstetric care.

Published
2000

77. Santé globale: une santé publique mondialisée.

Author

Buekens, Pierre, Bréart, G, Cot, M, Levêque, Alain, Massougbodji, A., López, M H Rodriguez, Buekens, Pierre, Bréart, G, Cot, M, Levêque, Alain, Massougbodji, A., and López, M H Rodriguez

Abstract

Editorial, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2011

78. [National survey on the use of induced labor by obstetricians. Study Group on Induced Labor]

Author

François GOFFINET, Humbert R, Clerson P, Hj, Philippe, Bréart G, and Cabrol D

Subjects
Analysis of Variance, Patient Selection, Private Practice, Obstetrics, Logistic Models, Pregnancy, Residence Characteristics, Health Care Surveys, Oxytocics, Surveys and Questionnaires, Practice Guidelines as Topic, Humans, Female, France, Labor, Induced, Practice Patterns, Physicians'
Abstract

A strong rise in the use of induced labor has been observed in France. The aim of this work was to analyze the different methods used for achieving induction of labor and their implications.One out of four French obstetricians were randomly selected to answer a questionnaire on their practice for achieving induction of labor. Four hundred of the 997 obstetricians answered the questionnaire. Univariate and multivariate analysis was applied.A high rate of induced labor was correlated with some areas of the country and with private practice. Certain methods were used in spite of opposing advice by experts in the field: elective induction of labor with unfavorable cervix, use of prostaglandins in elective induction of labor, induction of labor in cases of scarred uterus or breech presentation, use of misoprostol. Some methods were still used in spite of their poor efficacy: intravenous oxytocin used with unfavorable cervix, use of intravensou PGE2.This study would show that theory and practice are often distinctly different. Induction of labor is currently used on a far wider scale than ever before. We obviously need studies for careful assessment of the circumstances in which induction of labor is used in order to improve methods and indications of such a clinical practice.

Published
1999

79. Obstetric interventions for babies born before 28 weeks of gestation in Europe: results of the MOSAIC study

Author

Kollée, L A A, Cuttini, M, Delmas, D, Papiernik, E, den Ouden, A L, Agostino, R, Boerch, K, Bréart, G, Chabernaud, J-L, Draper, E S, Gortner, L, Künzel, W, Maier, R F, Mazela, J, Milligan, D, Van Reempts, P, Weber, T, Zeitlin, J, Kollée, L A A, Cuttini, M, Delmas, D, Papiernik, E, den Ouden, A L, Agostino, R, Boerch, K, Bréart, G, Chabernaud, J-L, Draper, E S, Gortner, L, Künzel, W, Maier, R F, Mazela, J, Milligan, D, Van Reempts, P, Weber, T, and Zeitlin, J

Abstract

Udgivelsesdato: 2009-Oct, OBJECTIVE: To describe obstetric intervention for extremely preterm births in ten European regions and assess its impact on mortality and short term morbidity. DESIGN: Prospective observational cohort study. SETTING: Ten regions from nine countries participating in the 'Models of Organising Access to Intensive Care for Very Preterm Babies in Europe' (MOSAIC) project. POPULATION: All births from 22 to 29 weeks of gestation (n = 4146) in 2003, excluding terminations of pregnancy. METHODS: Comparison of three obstetric interventions (antenatal corticosteroids, antenatal transfer and caesarean section for fetal indication) rates at 22-23, 24-25 and 26-27 weeks to that at 28-29 weeks and the association of the level of intervention with pregnancy outcome. MAIN OUTCOME MEASURES: Use of antenatal corticosteroids, antenatal transfer and caesarean section by two-week gestational age groups as well as a composite score of these three interventions. Outcomes included stillbirth, in-hospital mortality and intraventricular haemorrhage (IVH) grades III and IV and/or periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD). RESULTS: There were large differences between regions in interventions for births at 22-23 and 24-25 weeks. Differences were most pronounced at 24-25 weeks; in some regions these babies received the same care as babies of 28-29 weeks, whereas elsewhere levels of intervention were distinctly lower. Before 26 weeks and especially at 24-25 weeks, there was an association between the composite intervention score and mortality. No association was observed at 26-27 weeks. For survivors at 24-25 weeks, the intervention score was associated with higher rates of BPD, but not with IVH or PVL. CONCLUSIONS: There are large differences between European regions in obstetric practices at the lower limit of viability and these are related to outcome, especially at 24-25 weeks.

Published
2009

82. Apport d’une démarche d’assurance qualité de la production de l’information médicalisée pour l’enregistrement et le codage des mort-nés par le PMSI, dans les sites de naissances de l’Assistance publique–Hôpitaux de Paris (projet NEMOSIS)

Author

Serfaty, A., primary, Taille, C., additional, Buhl, C., additional, Christol, R., additional, Loulizi, H., additional, Leclerc, C., additional, Elhouseini, R., additional, Benifla, J.-L., additional, Coulomb, A., additional, Siffroi, J.-P., additional, Jouannic, J.-M., additional, Cisse, G., additional, Frenkiel, J., additional, Talvard, O., additional, Taright, N., additional, Brunel, L., additional, and Bréart, G., additional

Published
2013
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83. [Clinical value of umbilical Doppler. Results of controlled trials in high risk and low risk populations]

Author

François GOFFINET, Paris J, Nisand I, and Bréart G

Subjects
Pregnancy, Research Design, Pregnancy, High-Risk, Odds Ratio, Pregnancy Outcome, Humans, Multicenter Studies as Topic, Reproducibility of Results, Female, Ultrasonography, Prenatal, Umbilical Arteries, Randomized Controlled Trials as Topic
Abstract

In order to assess the clinical utility of the use of arterial umbilical Doppler velocimetry, we performed meta-analysis in high and low-risk pregnancies with randomized controlled trials. We included in the low-risk meta-analysis the data of the french multicentric study submit to publication.Exhaustive review of published and non published trials was performed; quality of trials was assessed before inclusion in meta-analysis. Mantel-Haenzel statistic method was used. We used odds ratio with 95% confidence interval (CI) to present results.Meta-analysis in the high-risk population performed with 13 trials (n = 9162) shows a 36% significant reduction in perinatal-deaths in the Doppler group. The reduction in deaths was also observed in perinatal deaths after exclusion of lethal malformation (OR = 0.62, CI:[0.45; 0.86]) and in stillbirths (OR = 0.54, CI:[0.29; 0.91]). There is no difference in maternal, obstetrical and other perinatal outcomes. Meta-analysis in the low-risk population performed with 4 trials (n = 11451) does not show any benefit in the Doppler group, in particular in perinatal deaths (OR = 0.90, Cl:[0.50; 1.60]).Use of umbilical Doppler velocimetry in high-risk pregnancies involve a one third reduction in perinatal mortality. This proved effect should induce obstetricians to performed systematically an umbilical Doppler in pregnancies "at fetal risk". On the other hand, there is no indication to perform an umbilical Doppler in an unselected or a low-risk population.

Published
1997

85. [Aspirin during pregnancy. Indications and modalities of prescription after the publication of the later trials]

Author

Uzan S, Philippe Merviel, Beaufils M, Bréart G, and Salat-Baroux J

Subjects
Clinical Trials as Topic, Fetal Growth Retardation, Aspirin, Angiotensin II, Pregnancy, High-Risk, Infant, Newborn, Antiphospholipid Syndrome, Pregnancy Complications, Pregnancy Trimester, First, Pre-Eclampsia, Pregnancy, Pregnancy Trimester, Second, Humans, Cyclooxygenase Inhibitors, Female, Ultrasonography
Abstract

Aspirin, an inhibitor of cyclo-oxygenase, is prescribed in a number of conditions related to abnormal production of prostaglandins including gravidic hypertension. Results of the most recent trials demonstrate that in patients with a past history of pre-eclampsia or intra-uterine growth retardation, a pathological Doppler examination of the uterus, a pathological angiotensin test or an antiphospholipid syndrome, prescription of aspirin at the dose of 100 mg/day can prevent recurrence or development of pre-eclampsia or intra-uterine growth retardation. Treatment should begin as soon as possible during pregnancy, certainly before development of clinical manifestations. After history taking and identification of possible contraindications, bleeding time (Ivy method) is recorded before and after prescription and should be lower than 8 minutes. In case bleeding time exceeds 10 minutes 10 to 15 days after initiating aspirin, doses may be reduced to 50 mg per day or even 50 mg every two or three days to reach the target level. Treatment should generally be continued up to 36 weeks gestation.

Published
1996

89. Selecting an indicator set for monitoring and evaluating perinatal health in Europe: Criteria, methods and results from the PERISTAT project

Author

Zeitlin, J., Wildman, K., Bréart, G., Alexander, S., Barros, H., Blondel, B., Buitendijk, S.E., Gissler, M., Macfarlane, A., Zeitlin, J., Wildman, K., Bréart, G., Alexander, S., Barros, H., Blondel, B., Buitendijk, S.E., Gissler, M., and Macfarlane, A.

Abstract

The PERISTAT project was charged with developing an indicator set for monitoring and describing perinatal health in Europe as part of the European Commission's Health Monitoring Programme, run by the Directorate General for Health and Consumer Protection (DG-SANCO), which is working towards the establishment of a comprehensive health monitoring system at the community level. To develop its recommendations, the PERISTAT project carried out an extensive review of existing perinatal health indicators and then implemented a DELPHI consensus process with its scientific advisory committee, a panel composed of clinicians, epidemiologists and statisticians, as well as with a panel of midwives. Consensus was achieved on 10 core and 23 recommended indicators using methods that drew on and consolidated previous work in this field. Twelve of these indicators were targeted for further development and the other 21 for immediate implementation. A feasibility study, reported in the rest of this issue, was put into place to assess these recommendations. © 2003 Elsevier Ireland Ltd. All rights reserved.

Published
2003

91. Anesthesia Mode for Cesarean Section and Mortality in Very Preterm Infants: An Epidemiologic Study in the EPIPAGE Cohort

Author

Laudenbach, V., primary, Mercier, F.J., additional, Rozé, J.C., additional, Larroque, B., additional, Ancel, P.Y., additional, Kaminski, M., additional, Bréart, G., additional, Diemunsch, P., additional, Subtil, D., additional, Lejus, C., additional, Fresson, J., additional, Arnaud, C., additional, Rachet, B., additional, Burguet, A., additional, and Cambonie, G., additional

Published
2010
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97. Neonatal and 5-Year Outcomes After Birth at 30-34 Weeks of Gestation

Author

Marret, S., primary, Ancel, P.Y., additional, Marpeau, L., additional, Marchand, L., additional, Pierrat, V., additional, Larroque, B., additional, Foix-L'Hélias, L., additional, Thiriez, G., additional, Fresson, J., additional, Alberge, C., additional, Rozé, J.C., additional, Matis, J., additional, Bréart, G., additional, and Kaminski, M., additional

Published
2008
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100. Comment anticiper l’évaluation de l’intérêt de santé publique des médicaments ?

Author

Massol, Jacques, primary, Puech, Alain, additional, Boissel, Jean-Pierre, additional, Alperovitch, A., additional, Bamberger, M., additional, Bégaud, B., additional, Blin, O., additional, Blin, P., additional, Bréart, G., additional, Brun Strang, C., additional, Buyse, M., additional, Castot, A., additional, Chauvenet, M., additional, Chicoye, A., additional, David, N., additional, De Bels, F., additional, De Sahb Berkovitch, R., additional, Dohin, E., additional, Fagnani, F., additional, Falissard, B., additional, Gastaldi-Menager, C., additional, Giri, I., additional, Haim, M., additional, Joubert, J.M., additional, Lapeyre-Mestre, M., additional, Lassale, C., additional, Marchant Ramirez, I., additional, Meyer, F., additional, Micallef, J., additional, Mollimard, M., additional, Moreau-Defarges, T., additional, Pazart, L., additional, Perret, L., additional, Pigeon, M., additional, Rumeau Pichon, C., additional, Tcheng, Ph., additional, Woler, M., additional, Zanetti, L., additional, and Zylberman, M., additional

Published
2007
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