Related Experiment Videos
[Regionalization of perinatal care and in utero referrals]
Insights
Improving outcomes for high-risk newborns requires specialized care. In France, only 15% of very premature infants are born in neonatal intensive care units, far from the 80% goal for better survival and reduced complications.
Area of Science:
- Perinatal health care
- Neonatal intensive care
- Public health policy
Context:
- Improving perinatal morbidity and mortality necessitates effective in utero referrals for high-risk infants, especially those born extremely prematurely.
- The success of these referrals hinges on the integration and coordination of regional perinatal healthcare networks.
- Current French healthcare practices fall short, with only 15% of infants born before 33 weeks gestation and under 1500g delivered in Level III maternity wards with neonatal intensive care units (NICUs).
Purpose:
- To analyze the contributing factors to the suboptimal organization of perinatal healthcare in France.
- To propose strategies for enhancing the organization of perinatal healthcare and achieving better outcomes for high-risk newborns.
Summary:
- Effective in utero referral to specialized centers is crucial for managing high-risk infants, particularly extremely premature ones, to improve survival and reduce long-term sequelae.
- The current French system's low rate (15%) of births in Level III NICUs for very premature infants highlights a significant gap.
- The study aims to identify barriers and suggest improvements for perinatal care organization.
Impact:
- Enhancing the coherence of regional perinatal healthcare networks can significantly improve survival and sequelae-free survival rates for very premature infants.
- Achieving the goal of 80% of high-risk infants being born in specialized centers could drastically reduce neonatal mortality and morbidity.
- Optimized perinatal care organization is essential for advancing neonatal health outcomes and reducing healthcare disparities.
Abstract:
Further improvement in perinatal morbidity and mortality figures implies in utero referral so high risk infants, particularly very early maturity infants, can be managed immediately in specialized centers. The success of such referrals depends directly on the coherence of the regional perinatal health care network. It has been demonstrated that the chances of survival and of sequelae-free survival are greater for very premature infants born in a center with a neonatal intensive care unit. The situation in France leaves room for improvement. Only 15% of the infants born before 33 months gestation and with birth weight under 1500 g are born in level III maternity wards equipped with a neonatal intensive care unit. The goal is 80%. We have tried to analyze the reasons behind this situation and propose ways to better organize perinatal health care.