Management of pregnancy based on healthcare consumption of women who delivered in France in 2015: Contribution of the national health data system (SNDS)

Piffaretti, Clara; Looten, Vincent; Rey, Sylvie; Fresson, Jeanne; Fagot-Campagna, A.; Tuppin, Philippe

doi:10.1016/j.jogoh.2018.05.014

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…6 Hospital discharge data are increasingly used to monitor newborn health, especially given widespread innovations to link data across hospital episodes and to improve discharge data quality by standardising coding practises. 7,8 A recent review, comparing existing morbidity indicators based on International Classification of Diseases (ICD) diagnosis and procedure codes, showed that some were narrowly defined, covering only specific morbidities (i.e. respiratory complications) or focussed only on specific populations, such as very preterm births or uncomplicated term births.…”

Section: Introductionmentioning

confidence: 99%

Measuring severe neonatal morbidity using hospital discharge data in France

Lebreton

Menguy

Fresson

et al. 2021

Paediatric Perinatal Epid

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Background Measuring infant health at birth is key for surveillance and research in obstetrics and neonatology, but there is no international consensus on morbidity indicators. The Neonatal Adverse Outcome Indicator (NAOI) is a composite indicator, developed in Australia, which measures the burden of severe neonatal morbidity using hospital discharge data. Objective To evaluate the applicability of the NAOI in France for surveillance and research. Methods We constituted a cohort of live births ≥24 weeks’ gestational age in Metropolitan France from 2014 to 2015 using hospital discharge, insurance claims and cause of death data. Outlier hospitals were identified using funnel plots of standardised morbidity ratios (SMR), and their coding patterns were assessed. We compared the NAOI and its component codes with published Australian and English data and estimated unadjusted and adjusted risk ratios for known risk factors for neonatal morbidity. Results We included 1,459,123 births (511 hospitals). Twenty‐eight hospitals had SMR above funnel plot control limits. Newborns with NAOI morbidities in these hospitals had lower mortality and shorter stays than in other hospitals. Amongst within‐limit hospitals, NAOI prevalence was 4.8%, comparable to Australia (4.6%) and England (5.4%). Most individual components had a similar prevalence, with the exception of respiratory support, intravenous fluid procedures and infection. NAOI was lowest at 39 weeks (2.2%) with higher risks for maternal age ≥40 (relative risk [RR] 1.47, 95% confidence interval [CI] 1.42, 1.51), state medical insurance (RR 1.60, 95% CI 1.52, 1.68), male sex (RR 1.21, 95% CI 1.19, 1.23) and birthweight <3rd percentile (RR 4.60, 95% CI 4.51, 4.69). Conclusions The NAOI provides valuable information on population prevalence of severe neonatal morbidity and its risk factors. Whilst the prevalence was similar in high‐income countries with comparable neonatal mortality levels, ensuring valid comparisons between countries and hospitals will require further work to harmonize coding procedures, especially for infection and respiratory morbidity.

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Section: Introductionmentioning

confidence: 99%

Measuring severe neonatal morbidity using hospital discharge data in France

Lebreton

Menguy

Fresson

et al. 2021

Paediatric Perinatal Epid

Self Cite

View full text Add to dashboard Cite

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“…Speci cally, these data comprised age group, socioprofessional category (SPC), region of residence, size of urban area, and parity. No signi cant difference in age group, region of residence or parity was observed between women participating in Covimater and the whole population of women in France who gave birth in a hospital maternity ward (i.e., 99% of French pregnant women population (27)).…”

Section: Survey Methodologymentioning

confidence: 92%

“…For the present study, women who voluntarily changed their pregnancy monitoring during the lockdown were de ned as those who reported at least one of the following in the questionnaire: (i) foregoing pregnancy examinations, (ii) voluntarily postponing or cancelling pregnancy consultations, (iii) delaying the start of monitoring (i.e., not starting monitoring despite a gestational age of over 15 weeks) (27).…”

Section: Changes In Pregnancy Monitoring At the Initiative Of Pregnant Womenmentioning

confidence: 99%

Impact of the SARS-CoV-2 Pandemic and First Lockdown on Pregnancy Monitoring in France: the COVIMATER Cross-sectional Study

Doncarli

Araújo

Crenn‐Hébert

et al. 2021

Preprint

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BackgroundIn the context of the SARS-CoV-2 pandemic, consultations and pregnancy monitoring examinations had to be reorganised urgently. In addition, women themselves may have postponed or cancelled their medical monitoring for organisational reasons, for fear of contracting the disease caused by SARS-CoV-2 (Covid-19) or for other reasons of their own. Delayed care can have deleterious consequences for both the mother and the child. Our objective was therefore to study the impact of the SARS-CoV-2 pandemic and the first lockdown in France on voluntary changes by pregnant women in the medical monitoring of their pregnancy and the associated factors.MethodsA cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 adult (>18 years old) pregnant women during the first French lockdown (March-May 2020). A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPRs). ResultsAlmost one women of five (23.4%) reported having voluntarily postponed or foregone at least one consultation or pregnancy check-up during the lockdown. Women who were professionally inactive (aPR=1.98, CI95%[1.24-3.16]), who had experienced serious disputes or violence during the lockdown (1.47, [1.00-2.16]), who felt they received little or no support (1.71, [1.07-2.71]), and those who changed health professionals during the lockdown (1.57, [1.04-2.36]) were all more likely to have voluntarily changed their pregnancy monitoring. Higher level of worry about the pandemic was associated with a lower probability of voluntarily changing pregnancy monitoring (0.66, [0.46 -0.96]).Conclusions Our results can guide prevention and support policies for pregnant women in the current and future pandemics.

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“…The two-month interval was chosen i) to avoid the memory bias associated with a longer interval, and ii) because the major recommended prevention measures had not changed in the two months after lockdown. No significant difference in available data for age group, region of residence, or parity was observed between the women participating in Covimater and women in the whole French population who gave birth in a hospital maternity ward (i.e., 99% of pregnant women in France ( Piffaretti et al, 2018 )).…”

Section: Methodsmentioning

confidence: 94%