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1. Intensity of perinatal care for extremely preterm babies and outcomes at a higher gestational age: evidence from the EPIPAGE-2 cohort study

Author

Andrei Scott Morgan, Babak Khoshnood, Caroline Diguisto, Laurence Foix L’Helias, Laetitia Marchand-Martin, Monique Kaminski, Jennifer Zeitlin, Gérard Bréart, François Goffinet, and Pierre-Yves Ancel

Subjects
Extreme prematurity, Newborn, Perinatal intensity, Activity, Obstetric, Neonatal, Pediatrics, RJ1-570
Abstract

Abstract Background Perinatal decision-making affects outcomes for extremely preterm babies (22–26 weeks’ gestational age (GA)): more active units have improved survival without increased morbidity. We hypothesised such units may gain skills and expertise meaning babies at higher gestational ages have better outcomes than if they were born elsewhere. We examined mortality and morbidity outcomes at age two for babies born at 27–28 weeks’ GA in relation to the intensity of perinatal care provided to extremely preterm babies. Methods Fetuses from the 2011 French national prospective EPIPAGE-2 cohort, alive at maternal admission to a level 3 hospital and delivered at 27–28 weeks’ GA, were included. Morbidity-free survival (survival without sensorimotor (blindness, deafness or cerebral palsy) disability) and overall survival at age two were examined. Sensorimotor disability and Ages and Stages Questionnaire (ASQ) result below threshold among survivors were secondary outcomes. Perinatal care intensity level was based on birth hospital, grouped using the ratio of 24–25 weeks’ GA babies admitted to neonatal intensive care to fetuses of the same gestation alive at maternal admission. Sensitivity analyses used ratios based upon antenatal steroids, Caesarean section, and newborn resuscitation. Multiple imputation was used for missing data; hierarchical logistic regression accounted for births nested within centres. Results 633 of 747 fetuses (84.7%) born at 27–28 weeks’ GA survived to age two. There were no differences in survival or morbidity-free survival: respectively, fully adjusted odds ratios were 0.96 (95% CI: 0.54 to 1.71) and 1.09 (95% CI: 0.59 to 2.01) in medium and 1.12 (95% CI: 0.63 to 2.00) and 1.16 (95% CI: 0.62 to 2.16) in high compared to low-intensity hospitals. Among survivors, there were no differences in sensorimotor disability or ASQ below threshold. Sensitivity analyses were consistent with the main results. Conclusions No difference was seen in survival or morbidity-free survival at two years of age among fetuses alive at maternal hospital admission born at 27–28 weeks’ GA, or in sensorimotor disability or presence of an ASQ below threshold among survivors. There is no evidence for an impact of intensity of perinatal care for extremely preterm babies on births at a higher gestational age.

Published
2020
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2. Intensity of perinatal care, extreme prematurity and sensorimotor outcome at 2 years corrected age: evidence from the EPIPAGE-2 cohort study

Author

Andrei S. Morgan, Laurence Foix L’Helias, Caroline Diguisto, Laetitia Marchand-Martin, Monique Kaminski, Babak Khoshnood, Jennifer Zeitlin, Gérard Bréart, Xavier Durrmeyer, François Goffinet, and Pierre-Yves Ancel

Subjects
Extreme prematurity, Newborn, Perinatal intensity, Activity, Obstetric, Neonatal, Medicine
Abstract

Abstract Background Emerging evidence suggests intensity of perinatal care influences survival for extremely preterm babies. We evaluated the effect of differences in perinatal care intensity between centres on sensorimotor morbidity at 2 years of age. We hypothesised that hospitals with a higher intensity of perinatal care would have improved survival without increased disability. Methods Foetuses alive at maternal admission to a level 3 hospital in France in 2011, subsequently delivered between 22 and 26 weeks gestational age (GA) and included in the EPIPAGE-2 national prospective observational cohort study formed the baseline population. Level of intensity of perinatal care was assigned according to hospital of birth, categorised into three groups using ‘perinatal intensity’ ratios (ratio of 24–25 weeks GA babies admitted to neonatal intensive care to foetuses of the same GA alive at maternal admission to hospital). Multiple imputation was used to account for missing data; hierarchical logistic regression accounting for births nested within centres was then performed. Results One thousand one hundred twelve foetuses were included; 473 survived to 2 years of age (126 of 358 in low-intensity, 140 of 380 in medium-intensity and 207 of 374 in high-intensity hospitals). There were no differences in disability (adjusted odds ratios 0.93 (95% CI 0.28 to 3.04) and 1.04 (95% CI 0.34 to 3.14) in medium- and high- compared to low-intensity hospitals, respectively). Compared to low-intensity hospitals, survival without sensorimotor disability was increased in the population of foetuses alive at maternal admission to hospital and in live-born babies, but there were no differences when considering only babies admitted to NICU or survivors. Conclusions No difference in sensorimotor outcome for survivors of extremely preterm birth at 2 years of age was found according to the intensity of perinatal care provision. Active management of periviable births was associated with increased survival without sensorimotor disability.

Published
2018
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3. A Case of Scrotoschisis with Exteriorization of Both Testes

Author

Peggy Alkefrawi, Olivier Chamond, Zeineb Laatiri, Nourhen Kloula, Sabine Irtan, Laurence Foix L’Helias, and Aurélie Pham

Subjects
Male, Pediatrics, Perinatology and Child Health, Testis, Scrotum, Humans, General Medicine, Pathology and Forensic Medicine
Abstract

Scrotoschisis is a congenital malformation characterized by testicular exstrophy through a scrotal defect.We report a full-term baby boy with exteriorization of both testes through a right parietal scrotal defect.Bilateral testes extrusion through a lateralized scrotoschisis can occur due to a scrotal septal defect.

Published
2022

4. Risk factors for hypoxic-ischemic encephalopathy in cases of severe acidosis: A case-control study

Author

Perrine Lorain, Alexandra Bower, Elsa Gottardi, Marc Dommergues, Laurence Foix L’Helias, Isabelle Guellec, and Gilles Kayem

Subjects
Asphyxia Neonatorum, Infant, Newborn, Obstetrics and Gynecology, Infant, General Medicine, Pregnancy, Risk Factors, Case-Control Studies, Hypoxia-Ischemia, Brain, Apgar Score, Humans, Female, Acidosis, Child
Abstract

The aim of the study was to identify the obstetric risk factors for hypoxic-ischemic encephalopathy (HIE) in infants with asphyxia at birth.This multicenter case-control study covered the 5-year period from 2014 through 2018 and included newborns ≥36 weeks of gestation with an umbilical pH at birth ≤7.0. Cases were newborns who developed moderate or severe HIE; they were matched with controls with pH ≤7.0 at birth over the same period without moderate or severe HIE. The factors studied were maternal, gestational, intrapartum, delivery-related, and neonatal characteristics. A multivariable analysis was performed to study the maternal, obstetric, and neonatal factors independently associated with moderate or severe HIE.Our review of the records identified 41 cases and 98 controls. Compared with controls, children with moderate or severe HIE had a lower 5-min Apgar score, lower umbilical artery pH, and higher cord lactate levels at birth and at 1 h of life. Obstetric factors associated with moderate or severe HIE were the occurrence of an acute event (adjusted odds ratio [aOR] 6.4; 95% confidence interval [CI] 1.8-22.5), maternal fever (aOR 3.5; 95% CI 1.0-11.9), and thick meconium during labor (aOR 2.9; 95% CI 1.0-8.6).HIE is associated with a lower 5-min Apgar score and with the severity of acidosis at birth and at 1 h of life. In newborns with a pH7.0 at birth, the occurrence of an acute obstetric event, maternal fever, and thick meconium are independent factors associated with moderate or severe HIE.

Published
2022

7. Association of Chorioamnionitis with Cerebral Palsy at Two Years after Spontaneous Very Preterm Birth: The EPIPAGE-2 Cohort Study

Author

Stéphane Marret, Jennifer Zeitlin, Barthélémy Tosello, Claude D'Ercole, Caroline Diguisto, Catherine Arnaud, Norbert Winer, Damien Subtil, RM Isabelle Monier, Laurence Foix L'Helias, Véronique Pierrat, Andrei S. Morgan, Mathilde Letouzey, Bruno Langer, François Goffinet, Héloïse Torchin, Catherine Gire, Thomas Schmitz, Pascal Boileau, Emeline Maisonneuve, Christophe Vayssière, Pierre-Yves Ancel, Louise Devisme, Julie Blanc, Loïc Sentilhes, Géraldine Gascoin, Thomas Desplanches, Florence Bodeau-Livinec, Aurélie Garbi, Jean-Christophe Rozé, Pierre Delorme, Gilles Kayem, Chloé Arthuis, Elsa Lorthe, Thierry Debillon, Instituto de Saúde Pública da Universidade do Porto, Sorbonne Université (SU), Université Paris Descartes - Paris 5 (UPD5), Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 (RADEME), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Hôpital Jeanne de Flandre [Lille], Université de Bordeaux (UB), Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Charles Nicolle [Rouen]-CHU Rouen, and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille

Subjects
Male, Cerebral palsy CP, medicine.medical_specialty, Fetal Membranes, Premature Rupture, Time Factors, [SDV]Life Sciences [q-bio], Population, Chorioamnionitis, Cerebral palsy, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, 030225 pediatrics, Cause of Death, medicine, cohort study, Very Preterm Birth, Humans, 030212 general & internal medicine, Prospective Studies, education, education.field_of_study, cerebral palsy, Obstetrics, business.industry, Cerebral Palsy, Gestational age, Infant, preterm birth, medicine.disease, chorioamnionitis, 3. Good health, intrauterine infection, Child, Preschool, Pediatrics, Perinatology and Child Health, Gestation, Premature Birth, Female, business, Premature rupture of membranes, Infant, Premature, Cohort study
Abstract

Objective To assess whether chorioamnionitis is associated with cerebral palsy (CP) or death at 2 years' corrected age in infants born before 32 weeks of gestation after spontaneous birth. Study design EPIPAGE-2 is a national, prospective, population-based cohort study of children born preterm in France in 2011; recruitment periods varied by gestational age. This analysis includes infants born alive after preterm labor or preterm premature rupture of membranes from 240/7 to 316/7 weeks of gestation. We compared the outcomes of CP, death at 2 years' corrected age, and “CP or death at age 2” according to the presence of either clinical chorioamnionitis or histologic chorioamnionitis. All percentages were weighted by the duration of the recruitment period. Results Among 2252 infants born alive spontaneously before 32 weeks of gestation, 116 (5.2%) were exposed to clinical chorioamnionitis. Among 1470 with placental examination data available, 639 (43.5%) had histologic chorioamnionitis. In total, 346 infants died before 2 years and 1586 (83.2% of the survivors) were evaluated for CP at age 2 years. CP rates were 11.1% with and 5.0% without clinical chorioamnionitis (P = .03) and 6.1% with and 5.3% without histologic chorioamnionitis (P = .49). After adjustment for confounding factors, CP risk rose with clinical chorioamnionitis (aOR 2.13, 95% CI 1.12-4.05) but not histologic chorioamnionitis (aOR 1.21, 95% 0.75-1.93). Neither form was associated with the composite outcome “CP or death at age 2.” Conclusions Among infants very preterm born spontaneously, the risk of CP at a corrected age of 2 years was associated with exposure to clinical chorioamnionitis but not histologic chorioamnionitis.

Published
2020
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8. Providing active antenatal care depends on the place of birth for extremely preterm births: the EPIPAGE 2 cohort study

Author

Gilles Kayem, Elie Azria, Babak Khoshnood, Monique Kaminski, Damien Subtil, Loïc Sentilhes, Pascal Boileau, Jean-Christophe Rozé, Caroline Diguisto, Bruno Langer, Valérie Benhammou, François Goffinet, Pierre-Yves Ancel, Elsa Lorthe, Laurence Foix L'Helias, Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA) (SBIM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut national du cancer [Boulogne] (INCA)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Tours (CHRU de Tours), Université Francois Rabelais [Tours], Departement Hopital Universitaire, Partenaires INRAE, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de gynécologie-obstétrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Physiopathologie des Adaptations Nutritionnelles (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier iItercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Hôpital de Hautepierre, Department of Obstetrics and Gynecology, University Hospital Bordeaux, Bordeaux, France., Hôpital Jeanne de Flandre [Lille], Hôpital Saint Joseph, AP-HP Hôpitaux Universitaires Paris Centre, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut national du cancer [Boulogne] (INCA)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA)

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Population, Gestational Age, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Residence Characteristics, 030225 pediatrics, Infant Mortality, medicine, Humans, Caesarean section, Extreme Preterm Birth, education, education.field_of_study, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Infant, Newborn, Infant, Obstetrics and Gynecology, Gestational age, Prenatal Care, General Medicine, Place of birth, medicine.disease, Infant mortality, 3. Good health, Survival Rate, Extreme preterm birth, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Female, active antenatal care, France, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study
Abstract

International audience; Survival rates of infants born before 25 weeks of gestation are low in France and have not improved over the past decade. Active perinatal care increases these infants’ likelihood of survival.ObjectiveOur aim was to identify factors associated with active antenatal care, which is the first step of proactive perinatal care in extremely preterm births.MethodsThe population included 1020 singleton births between 220/6and 260/6weeks of gestation enrolled in the Etude Epidémiologique sur les Petits Ages Gestationnels 2 study, a French national population-based cohort of very preterm infants born in 2011. The main outcome was ’active antenatal care’ defined as the administration of either corticosteroids or magnesium sulfate or delivery by caesarean section for fetal rescue. A multivariable analysis was performed using a two-level multilevel model taking into account the maternity unit of delivery to estimate the adjusted ORs (aORs) of receiving active antenatal care associated with maternal, obstetric and place of birth characteristics.resultsAmong the population of extremely preterm births, 42% received active antenatal care. After standardisation for gestational age, regional rates of active antenatal care varied between 22% (95% CI 5% to 38%) and 61% (95% CI 44% to 78%). Despite adjustment for individual and organisational characteristics, active antenatal care varied significantly between maternity units (p=0.03). Rates of active antenatal care increased with gestational age with an aOR of 6.46 (95% CI 3.40 to 12.27) and 10.09 (95% CI 5.26 to 19.36) for infants born at 25 and 26 weeks’ gestation compared with those born at 24 weeks. No other individual characteristic was associated with active antenatal care.conclusionEven after standardisation for gestational age, active antenatal care in France for extremely preterm births varies widely with place of birth. The dependence of life and death decisions on place of birth raises serious ethical questions.Survival rates of infants born before 25 weeks of gestation are low in France and have not improved over the past decade. Active perinatal care increases these infants’ likelihood of survival.ObjectiveOur aim was to identify factors associated with active antenatal care, which is the first step of proactive perinatal care in extremely preterm births.MethodsThe population included 1020 singleton births between 220/6and 260/6weeks of gestation enrolled in the Etude Epidémiologique sur les Petits Ages Gestationnels 2 study, a French national population-based cohort of very preterm infants born in 2011. The main outcome was ’active antenatal care’ defined as the administration of either corticosteroids or magnesium sulfate or delivery by caesarean section for fetal rescue. A multivariable analysis was performed using a two-level multilevel model taking into account the maternity unit of delivery to estimate the adjusted ORs (aORs) of receiving active antenatal care associated with maternal, obstetric and place of birth characteristics.resultsAmong the population of extremely preterm births, 42% received active antenatal care. After standardisation for gestational age, regional rates of active antenatal care varied between 22% (95% CI 5% to 38%) and 61% (95% CI 44% to 78%). Despite adjustment for individual and organisational characteristics, active antenatal care varied significantly between maternity units (p=0.03). Rates of active antenatal care increased with gestational age with an aOR of 6.46 (95% CI 3.40 to 12.27) and 10.09 (95% CI 5.26 to 19.36) for infants born at 25 and 26 weeks’ gestation compared with those born at 24 weeks. No other individual characteristic was associated with active antenatal care.conclusionEven after standardisation for gestational age, active antenatal care in France for extremely preterm births varies widely with place of birth. The dependence of life and death decisions on place of birth raises serious ethical questions.

Published
2017
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9. Neonatal Outcomes in Extremely Preterm Newborns Admitted to Intensive Care after No Active Antenatal Management: A Population-Based Cohort Study

Author

Franck Perrotin, Caroline Diguisto, Laurence Foix L'Helias, Gilles Kayem, Monique Kaminski, François Goffinet, Andrei S. Morgan, Babak Khoshnood, and Pierre-Yves Ancel

Subjects
Adult, medicine.medical_specialty, Neonatal intensive care unit, Population, Gestational Age, Lung injury, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive care, Intensive Care Units, Neonatal, Infant Mortality, medicine, Humans, 030212 general & internal medicine, education, education.field_of_study, business.industry, Obstetrics, Infant, Newborn, Gestational age, Infant, Retinopathy of prematurity, Prenatal Care, medicine.disease, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Female, France, business, Cohort study
Abstract

Objective To evaluate the association between active antenatal management and neonatal outcomes in extremely preterm newborns admitted to a neonatal intensive care unit (NICU). Study design This population-based cohort study was conducted in 25 regions of France. Infants born in 2011 between 220/7 and 266/7 weeks of gestation and admitted to a NICU were included. Infants with lethal congenital malformations or death in the delivery room were excluded. A multilevel multivariable analysis was performed, accounting for clustering by mother (multiple pregnancies) and hospital plus individual characteristics, to estimate the association between the main exposure of no active antenatal management (not receiving antenatal corticosteroids, magnesium sulfate, or cesarean delivery for fetal indications) and a composite outcome of death or severe neonatal morbidity (including severe forms of brain or lung injury, retinopathy of prematurity, and necrotizing enterocolitis). Results Among 3046 extremely preterm births, 783 infants were admitted to a NICU. Of these, 138 (18%) did not receive active antenatal management. The risk of death or severe morbidity was significantly higher for infants without active antenatal management (crude OR, 2.60; 95% CI, 1.44-4.66). This finding persisted after adjustment for gestational age (OR, 2.08; 95% CI, 1.19-3.62) and all confounding factors (OR, 1.86; 95% CI, 1.09-3.20). Conclusions The increased risk of severe neonatal outcomes for extremely preterm babies admitted to a NICU without optimal antenatal management should be considered in individual-level decision making and in the development of professional guidelines for the management of extremely preterm births.

Published
2018

10. Impact of Latency Duration on the Prognosis of Preterm Infants after Preterm Premature Rupture of Membranes at 24 to 32 Weeks' Gestation: A National Population-Based Cohort Study

Author

Claude D'Ercole, Michel Dreyfus, Pierre Delorme, Héloïse Torchin, Bruno Langer, Laurence Foix L'Helias, Monique Kaminski, Jacques-Emmanuel Galimard, François Goffinet, Loïc Sentilhes, Christophe Vayssière, Pierre-Yves Ancel, Gilles Kayem, Bruno Carbonne, Norbert Winer, Cécile Lebeaux, Elsa Lorthe, Catherine Arnaud, Thierry Debillon, Damien Subtil, 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) ), Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Recherche Agronomique ( INRA ) -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 Descartes - Paris 5 ( UPD5 ), Université Sorbonne Paris Cité ( USPC ), DHU Risques Et Grossesse, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Formation Doctorale [Paris 6] ( IFD ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), P1419 Unité de Recherche Clinique-Centre d’Investigations Cliniques, CHU Cochin [AP-HP], Department of Obstetrics and Gynecologyl, Hôpital de Hautepierre [Strasbourg], Hôpital Jeanne de Flandre [Lille], Centre Hospitalier Universitaire de Bordeaux, Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Fédérale Toulouse Midi-Pyrénées, Centre Hospitalier Princesse Grace, Department of Neonatal Pediatrics, Centre Hospitalier Universitaire de Grenoble, Department of Obstetrics and Gynecology, Hôpital de l'Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris ( AP-HP ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre Hospitalier Universitaire de Caen, Centre Hospitalier Universitaire de Toulouse, Physiologie des Adaptations Nutritionnelles ( PhAN ), Institut National de la Recherche Agronomique ( INRA ) -Université de Nantes ( UN ), Helsinki University Central Hospital, Institut de Formation Doctorale, Université Pierre et Marie Curie (Paris 6), Sorbonne Universités, French Institute of Public Health Research/Institute of Public Health, French Health Ministry, National Institute of Health and Medical Research [INSERM], National Institute of Cancer, National Solidarity Fund for Autonomy [CNSA], National Research Agency through the French EQUIPEX program of Investments for the Future [ANR-11-EQPX-0038], PREMUP Foundation, Societe Francaise de Medecine Perinatale (SFMP), Journees Francophones de Recherche en Neonatalogie (JFRN), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), 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), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), UPMC - Institut de Formation Doctorale (IFD ), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Bordeaux [Bordeaux], 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), Hôpital de l'Hôtel-Dieu, Assistance Publique - Hôpitaux de Paris (AP-HP), Assistance Publique - Hôpitaux de Marseille (APHM), Physiologie des Adaptations Nutritionnelles [UMR_A1280] (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Sorbonne Université (SU), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse (UT), Centre Hospitalier Universitaire [Grenoble] (CHU), Service Obstétrique [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and ProdInra, Archive Ouverte

Subjects
Male, Pediatrics, medicine.medical_specialty, Fetal Membranes, Premature Rupture, Time Factors, [SDV]Life Sciences [q-bio], Population, Gestational Age, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Infant Mortality, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, education, Prospective cohort study, Survival rate, Physiologie des adaptations nutritionnelles, education.field_of_study, 030219 obstetrics & reproductive medicine, [ SDV ] Life Sciences [q-bio], business.industry, Infant, Newborn, Gestational age, Infant, Nantes, medicine.disease, Prognosis, 3. Good health, Survival Rate, [SDV] Life Sciences [q-bio], Premature birth, Pediatrics, Perinatology and Child Health, Gestation, Premature Birth, Female, France, business, Premature rupture of membranes, Infant, Premature
Abstract

Objective To assess the impact of latency duration on survival, survival without severe morbidity, and early-onset sepsis in infants born after preterm premature rupture of membranes (PPROM) at 24-32 weeks' gestation. Study design This study was based on the prospective national population-based Etude Epidemiologique sur les Petits Ages Gestationnels 2 cohort of preterm births and included 702 singletons delivered in France after PPROM at 24-32 weeks' gestation. Latency duration was defined as the time from spontaneous rupture of membranes to delivery, divided into 4 periods (12 hours to 2 days [reference], 3-7 days, 8-14 days, and >14 days). Multivariable logistic regression was used to assess the relationship between latency duration and survival, survival without severe morbidity at discharge, or early-onset sepsis. Results Latency duration ranged from 12 hours to 2 days (18%), 3-7 days (38%), 8-14 days (24%), and >14 days (20%). Rates of survival, survival without severe morbidity, and early-onset sepsis were 93.5% (95% CI 91.894.8), 85.4% (82.4-87.9), and 3.4% (2.0-5.7), respectively. A crude association found between prolonged latency duration and improved survival disappeared on adjusting for gestational age at birth (aOR 1.0 [reference], 1.6 [95% CI 0.8-3.2], 1.2 [0.5-2.9], and 1.0 [0.3-3.2] for latency durations from 12 hours to 2 days, 3-7 days, 8-14 days, and >14 days, respectively). Prolonged latency duration was not associated with survival without severe morbidity or early-onset sepsis. Conclusion For a given gestational age at birth, prolonged latency duration after PPROM does not worsen neonatal prognosis.

Published
2017
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11. Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

Author

Mohamed Ali Lachtar, Laurence Foix L'Helias, Aude du Mesniladelee, Inès de Montgolfier, Delphine Mitanchez, V. Champion, and François Kieffer

Subjects
medicine.medical_specialty, Pediatrics, medicine.diagnostic_test, biology, Central Line Infection, medicine.drug_class, business.industry, C-reactive protein, Antibiotics, Antimicrobial, Procalcitonin, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, medicine, biology.protein, Blood culture, Observational study, 030212 general & internal medicine, Neonatology, business
Abstract

Background: Duration of antibiotic treatment in neonatal late onset sepsis is empirical. Objectives: a) To study the evolution of procalcitonin during treatment of secondary sepsis in new-borns, b) To evaluate the reduction of antibiotic exposure using its serial measurements. Methods: This single-center prospective observational study was conducted in a level II neonatology unit in the Armand Trousseau Hospital in Paris, France. All neonates hospitalized in the unit between December 2011 and January 2013 with suspected infection after 5 days of life and serum procalcitonin concentration >0.6 μg/L were included. Serial procalcitonine, C-reactive protein and blood culture survey was performed during antimicrobial therapy. Antimicrobial therapy was administered for 10 days after the last positive blood culture. Results: 54 infective episodes were observed in 46 neonates, born at a mean term of 32 weeks (range: 26-40) and infected at mean age of 19 days (7-40). Staphylococci was found in 31 infective episodes (57.4%), other microorganisms in 12 (22.2%), and none bacteria in 11 episodes (20.4%). The main cause was central line infection (85.2%). On day 5, 80% of procalcitonin measurements were

Published
2016
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12. Ages and stages questionnaires: Feasibility of postal surveys for child follow-up

Author

Jean Bouyer, Laurence Foix L'Helias, P. Troude, Elise de La Rochebrochard, Jane Squires, Service de Santé Publique [Hôpital Fernand-Widal - APHP] (CeGIDD), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centres gratuits d'information, de dépistage et de diagnostic [Paris 13] (CeGIDD), University of Oregon [Eugene], Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Institut national d'études démographiques (INED)

Subjects
medicine.medical_specialty, Pediatrics, Gross motor skill, Population, [SHS.DEMO]Humanities and Social Sciences/Demography, 03 medical and health sciences, Postal questionnaire, MESH: Child Development, Follow-Up Studies, Surveys and Questionnaires, 0302 clinical medicine, Child Development, 030225 pediatrics, Epidemiology, medicine, Humans, Mass Screening, Postal Service, 030212 general & internal medicine, Neonatology, education, Response rate (survey), education.field_of_study, business.industry, 4. Education, Infant, Newborn, Infant, Obstetrics and Gynecology, Child development, Child, Preschool, Family medicine, Pediatrics, Perinatology and Child Health, Cohort, Feasibility Studies, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Patient Participation, business, Infant, Premature
Abstract

Background The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment. Aims To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population. Study design Follow-up study by postal questionnaire at 12 and 36 months, using the ASQ. Subjects: 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs. Outcome measure Response rates and French ASQ results at 12 and 36 months. The ASQ was scored as indicated in the manual. Results A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36 months they tended to be associated with both birth and family socio-demographic characteristics. Conclusions Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed.

Published
2011
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13. Apgar scores reported in personal child health records: Validity for epidemiological studies?

Author

P. Troude, C. Castel, Elise de La Rochebrochard, Anne-Marie Raison-Boulley, Laurence Foix L'Helias, Jean Bouyer, Institut national d'études démographiques (INED), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Foch [Suresnes], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), de La Rochebrochard, Elise, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Population, Gross motor skill, [SHS.DEMO]Humanities and Social Sciences/Demography, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, 030225 pediatrics, Epidemiology, medicine, Humans, Apgar score, 030212 general & internal medicine, Neonatology, education, Response rate (survey), Medical records, education.field_of_study, [SHS.DEMO] Humanities and Social Sciences/Demography, business.industry, 4. Education, Medical record, Infant, Newborn, Infant, Newborn, Child development, Epidemiologic Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pediatrics, Perinatology and Child Health, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Clinical psychology
Abstract

International audience; BACKGROUND: The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment.AIMS: To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population.STUDY DESIGN: Follow-up study by postal questionnaire at 12 and 36 months, using the ASQ.SUBJECTS: 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs.OUTCOME MEASURE: Response rates and French ASQ results at 12 and 36 months. The ASQ was scored as indicated in the manual.RESULTS: A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36 months they tended to be associated with both birth and family socio-demographic characteristics.CONCLUSIONS: Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed.

Published
2008
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14. Perinatal factors reported by mothers: do they agree with medical records?

Author

Laurence Foix L'Helias, C. Castel, Anne-Marie Raison-Boulley, Christine Pichon, Jean Bouyer, Elise de La Rochebrochard, P. Troude, Santé reproductive, sexualité, infection à VIH - épidémiologie, démographie, sciences sociales, Institut national d'études démographiques (INED)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Service de Pédiatrie et Réanimations néonatales [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Foch [Suresnes], Centre Hospitalier Intercommunal de Créteil (CHIC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Institut national d'études démographiques (INED), 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), de La Rochebrochard, Elise, AP-HP - Hôpital Antoine Béclère [Clamart], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Adult, medicine.medical_specialty, Pediatrics, Epidemiology, Birth weight, Mothers, [SHS.DEMO]Humanities and Social Sciences/Demography, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Medical Records, 03 medical and health sciences, 0302 clinical medicine, Memory, Pregnancy, 030225 pediatrics, Surveys and Questionnaires, Confidence Intervals, Odds Ratio, Medicine, Birth Weight, Humans, 030212 general & internal medicine, [SHS.DEMO] Humanities and Social Sciences/Demography, business.industry, Medical record, Public health, Infant, Newborn, Gestational age, Infant, Reproducibility of Results, Middle Aged, medicine.disease, Newborn, Child development, 3. Good health, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Perinatal Care, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Prenatal Exposure Delayed Effects, Apgar Score, Apgar score, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, business
Abstract

International audience; As perinatal events have been linked with diseases of later onset, epidemiological studies on child development and adult health require information on the perinatal period. When national neonatal registers do not exist, review of medical records may be impractical. However, neonatal information could be obtained by asking mothers to complete a postal questionnaire using data from the Personal Child Health Record (PCHR). We assessed agreement between medical records and mothers' reports for information on delivery and the newborn's condition at birth, based on the PCHR, a short time after delivery. Of 711 women giving birth in 3 French hospitals and invited to participate in the study, 580 (82%) completed a postal questionnaire 6 weeks after delivery, copying the data recorded in the PCHR when available. Information on pregnancy, delivery and the newborn's health at birth was independently extracted from medical records by physicians of the maternity departments. Agreement between medical records and maternal reports for a range of perinatal factors was assessed in 580 newborn-mother dyads using kappa coefficients. Agreement was excellent for first and second stages of delivery, gestational age, birth weight, birth size and head circumference (kappa coefficients 0.80-1.00) and good for hospitalization during pregnancy, but poor for Apgar scores. With this exception, mothers' reports appeared reliable when compared with medical records. As PCHRs exist in most developed countries, this approach could be used in epidemiological studies on child development to increase the reliability of mothers' reports of their newborn's condition at birth.

Published
2007
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15. Prenatal parental involvement in decision for delivery room management at 22-26 weeks of gestation in France - The EPIPAGE-2 Cohort Study.

Author

Cerise Levaillant, Laurence Caeymaex, Hélène Béhal, Monique Kaminski, Caroline Diguisto, Barthélémy Tosello, Elie Azria, Olivier Claris, Pierre Bétrémieux, Laurence Foix L'Hélias, Patrick Truffert, and EPIPAGE 2 Extreme Prematurity Group

Subjects
Medicine, Science
Abstract

ObjectiveOur main objective was to examine if parental prenatal preferences predict delivery-room management of extremely preterm periviable infants. The secondary objectives were to describe parental involvement and the content of prenatal counseling given to parents for this prenatal decision.DesignProspective study of neonates liveborn between 22 and 26 weeks of gestation in France in 2011 among the neonates included in the EPIPAGE-2 study.Setting18 centers participating in the "Extreme Prematurity Group" substudy of the EPIPAGE-2 study.Patients302 neonates liveborn between 22-26 weeks among which 113 with known parental preferences while parental preferences were unknown or unavailable for 186 and delivery room management was missing for 3.ResultsData on prenatal counseling and parental preferences were collected by a questionnaire completed by professionals who cared for the baby at birth; delivery room (DR) management, classified as stabilization or initiation of resuscitation (SIR) vs comfort care (CC). The 113 neonates studied had a mean (SD) gestational age of 24 (0.1) weeks. Parents of neonates in the CC group preferred SIR less frequently than those with neonates in the SIR group (16% vs 88%, p < .001). After multivariate analysis, preference for SIR was an independent factor associated with this management. Professionals qualified decisions as shared (81%), exclusively medical (16%) or parental (3%). Information was described as medical with no personal opinion (71%), complete (75%) and generally pessimistic (54%).ConclusionParental involvement in prenatal decision-making did not reach satisfying rates in the studied setting. When available, prenatal parental preference was a determining factor for DR management of extremely preterm neonates. Potential biases in the content of prenatal counselling given to parents need to be evaluated.

Published
2019
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16. Effect of maternal obesity on birthweight and neonatal fat mass: A prospective clinical trial.

Author

Delphine Mitanchez, Sophie Jacqueminet, Jacky Nizard, Marie-Laure Tanguy, Cécile Ciangura, Jean-Marc Lacorte, Céline De Carne, Laurence Foix L'Hélias, Pascale Chavatte-Palmer, Marie-Aline Charles, and Marc Dommergues

Subjects
Medicine, Science
Abstract

To discriminate the effect of maternal obesity and gestational diabetes on birth weight and adipose tissue of the newborn.Normal BMI women (group N, n = 243; 18.5≤ BMI

Published
2017
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17. A randomized EPIREMED protocol study on the long-term visuo spatial effects of very preterm children with a working memory deficit

Author

Catherine Gire, Any Beltran Anzola, Monique Kaminski, Karine Baumstarck, Pierre-Yves Ancel, Julie Berbis, for EPIREMED-Study Group, Hôpital Nord [CHU - APHM], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), for EPIREMED-Study Group: Meriem Zahed, Patricia Garcia, Tristan Desiles, Ludovic Zahed, Mélodie Pache, Gwenaëlle Menard, Nathalie Bednarek Weirauch, Karine Voirin, Virginie Verriere, Gilles Cambonie, Claire Lerat, Maythé Poujol, Olivier Claris, Sophie Rubio Gurung, Eliane Basson, Melanie Rodriguez, Anne Rannaud, Johanna Boulant, Thierry Debillon, Isabelle Pin, Karine Guichardet, Caroline Tournegros, Laurence Foix L'Helias, Delphine Mitanchez, Jennifer Sommer, Hélène Ruys Masson, Michele Granier, Marylène Riou, Dalia Mignot, Bernard Guillois, Valérie Dorriere Datin, Mireille Denaveaut Boulay, Delphine Rots, Jean-Michel Hascot, Hélène Deforge, Sabine Guignon, Pierre Kuhn, Anne de Saint Martin, Claire Zores Koenig, Hélène Musmeaux, Lucille Schneider, Carole Ramousset, Coralie Mangin, Bénédicte Lecomte, Angélique Pannetier, Emmanuelle Rochette, Nelly Goudon-Dubois, Julie Oertel, Sandrine La Planeta, Stéphane Marret, Marie Lemarchand, Nathalie Mestre, Hugues Patural, Sophie Flori, Jean-Christophe Roze, Charlotte Coudronniere, Hamida Martin, Alix Laurent, Elie Saliba, Patrick Zander, Eva Aoustin, Catherine Arnaud, Emeline Dubois, Stephanie Iannuzzi, Carine Duffaut, Isabelle Souksi Medioni, Magali Rebattel, Elodie Falque, Nathalie Rumeau, Valérie Benhammou, Laetitia Marchand-Martin, Samira Medjahed, Malbec, Odile, and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Adolescent, [SDV]Life Sciences [q-bio], Spatial memory, Pediatrics, RJ1-570, Executive functions, 03 medical and health sciences, Study Protocol, 0302 clinical medicine, Quality of life, Very preterm children, 030225 pediatrics, Medicine, Humans, Prospective Studies, Visuospatial index, Child, Randomized Controlled Trials as Topic, Memory Disorders, Intelligence quotient, Wechsler Preschool and Primary Scale of Intelligence, Working memory, business.industry, 4. Education, Neuropsychology, Infant, Newborn, Cognitive training, [SDV] Life Sciences [q-bio], Memory, Short-Term, Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Quality of Life, business, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Background Very preterm children generally perform poorly in executive functions and particularly in working memory. Adaptive training tasks encouraging these children to work continuously on their personal working memory capacity can be very useful. Above all in preschool-age children, several cognitive training programs focused on improving working memory capacity. Cogmed is a computerized visuospatial cognitive training program that improves working memory in children and adolescents with attention-deficit/hyperactivity disorder. The main objective is to assess the long-term effects (18 months) of cognitive training (Cogmed) on visuospatial processing in preschool-age very preterm children with working memory impairment. Methods The EPIREMED study is a prospective, randomized, controlled, multicentric trial nested in a population based epidemiological survey. An intervention group (Cogmed cognitive training) and a control group (standard care management) will compare children aged 5½ to 6 years, born between 24- and 34-weeks’ gestational age, with a global intelligence quotient > 70 and a working memory index Discussion This project’s primary goal is to demonstrate the necessity of early visuospatial memory assessment within the vulnerable population of very preterm children, and to prove the feasibility and efficacy of computerized cognitive training using online software programs. A better global neuropsychological development improvement (visuospatial processing and other far transfer) can be expected with an improvement in learning and decreased behavioral problems. In the long term, these improvements might also reduce those global costs linked to the consequences of extreme prematurity. Trial registration NCT02757794 (registered on 2nd May 2016 at ClinicalTrial.gov).

Published
2021
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