Ancel P Y, du Mazaubrun C, Bréart G
Unité de Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes (INSERM-U149), 123, boulevard de Port-Royal, 75014 Paris.
J Gynecol Obstet Biol Reprod (Paris). 2001 Feb;30(1 Suppl):48-54.
To estimate stillbirth rate et neonatal mortality in very preterm infants in relation to gestational age at birth, place of delivery, and type of birth.
This study includes neonates from the EPIPAGE cohort survey, born between 22 and 32 weeks of gestation, in the Paris area from the first of February to the 31(st) of July 1997. Stillbirth rate and mortality before hospital discharge were studied. Level III facilities were defined by facilities that had an obstetric ward and intensive care unit for the newborn on the same site.
Of the 772 neonates, 58% were born in level III centers. This percentage increased to 71% for multiple births. Mortality (stillbirth rate and mortality before discharge) of neonates born in level III was lower than the observed for neonates born in other centers (22.9% versus 45.8%). This difference was mainly due to difference in stillbirth rate and mortality in the delivery room.
Differences in perinatal and neonatal mortality were observed between maternity units. It may reflect differences in attitudes. The explaination of such differences should be based only on long term outcome.
评估极早产儿的死产率及新生儿死亡率与出生孕周、分娩地点和分娩类型的关系。
本研究纳入了1997年2月1日至7月31日在巴黎地区出生于孕22至32周的EPIPAGE队列研究中的新生儿。研究了死产率及出院前死亡率。三级医疗机构定义为在同一地点设有产科病房和新生儿重症监护病房的机构。
772例新生儿中，58%在三级中心出生。多胞胎出生的这一比例增至71%。在三级中心出生的新生儿死亡率（死产率及出院前死亡率）低于在其他中心出生的新生儿（22.9%对45.8%）。这种差异主要是由于产房内死产率及死亡率的不同。
不同产科单位的围产期及新生儿死亡率存在差异。这可能反映了态度上的差异。对此类差异的解释应仅基于长期结局。
