Document Detail


Frequency, causes and avoidability of outborn births in a French regional perinatal network.
MedLine Citation:
PMID:  24965974     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the rate and circumstances of outborn deliveries within a French perinatal network, and to determine their avoidability.
STUDY DESIGN: Cohort study including preterm infants <33 weeks gestation and/or weighing <1500g born outside a level III maternity unit in Lower Normandy region, France, in 2008-2010. In 2008 and 2009, only neonates transferred to the Caen University Teaching Hospital (CHU) were included. In 2010, all outborn neonates in the region were included by means of a medical information system program. A panel of 7 experts was set up to determine the avoidability of each outborn case using a two-stage modified Delphi procedure. Inter-expert agreement was evaluated using the kappa index.
RESULTS: Sixty-four cases (71 neonates) were included. The outborn rate in 2010 was 16.1% (40/248, 95% CI (116-207%)). The most common reason for delivery was spontaneous onset of labour (57.8%). In 12 cases, the place of birth (level 2b maternity unit) was considered to be appropriate by the experts (term ≥32WG), but 8 cases involved infants of low birth weight (<1500g). For the 52 cases born in inappropriate sites, 9.6% were considered to be avoidable (kappa index=0.42 (p<10-3)).
CONCLUSION: Our outborn rate meets regionalisation targets. Our method of expert evaluation identified a small percentage of avoidable births in inappropriate sites. Regular reassessment of obstetric practices and good coordination between network actors are crucial to improve the management of pregnancies at risk of outborn delivery.
Authors:
Christelle Lecoeur; Pascal Thibon; Ludovic Prime; Pierre-Yves Mercier; Pierre Balouet; Luc Durin; Grégory Deon; Paul Lefevre; Xavier Le Coutour; Bernard Guillois; Michel Dreyfus
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-21
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  179C     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-6-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  22-26     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Ireland Ltd.
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