{"id":3013,"date":"2020-03-29T16:29:43","date_gmt":"2020-03-29T14:29:43","guid":{"rendered":"https:\/\/fhu-premimpact.org\/?post_type=publication&#038;p=3013"},"modified":"2020-12-10T16:37:54","modified_gmt":"2020-12-10T15:37:54","slug":"understanding-high-rates-of-stillbirth-and-neonatal-death-in-a-disadvantaged-high-migrant-district-in-france-a-perinatal-audit","status":"publish","type":"publication","link":"https:\/\/fhu-premimpact.org\/en\/publications\/understanding-high-rates-of-stillbirth-and-neonatal-death-in-a-disadvantaged-high-migrant-district-in-france-a-perinatal-audit\/","title":{"rendered":"Understanding high rates of stillbirth and neonatal death in a disadvantaged, high-migrant district in France: A perinatal audit."},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Abstract<\/h4>\n\n\n\n<p><strong>Introduction:<\/strong> The objective of this study is to investigate factors associated with risks of perinatal death in a disadvantaged, high-migrant French district with mortality rates above the national average.<\/p>\n\n\n\n<p><strong>Material and methods:<\/strong> The study design is a perinatal audit in 2014 in all 11 maternity units in the Seine-Saint-Denis district (25 037 births). The data come from medical chart abstraction, maternal interviews and peer assessor confidential review of deaths. A representative sample of live births in the same district, from the 2010 French Perinatal Survey, was used for comparisons (n = 429). The main outcome measures were stillbirth and neonatal death (0-27 days) at \u226522 weeks of gestation.<\/p>\n\n\n\n<p><strong>Results:<\/strong> The audit included 218 women and 227 deaths (156 stillbirths, 71 neonatal deaths); 75 women were interviewed. In addition to primiparity and multiple pregnancy, overweight and obesity increased mortality risks (50% of cases, adjusted odds ratios [aOR] 1.7, 95% confidence interval [CI] 1.1-2.8, and aOR 1.9 [95% CI 1.1-3.2], respectively) as did the presence of preexisting medical\/obstetric conditions (28.6% of cases, aOR 3.2, 95% CI 2.0-5.3). Problems accessing or complying with care were noted in 25% of medical records and recounted in 50% of interviews. Assessors identified suboptimal factors in 73.2% of deaths and judged 33.9% to be possibly or probably preventable. Care not adapted to risk factors and poor healthcare coordination were frequent suboptimal factors. Possibly preventable deaths were higher (P &lt; .05) for women with gestational diabetes or hypertension (44.6%) than women without (29.0%).<\/p>\n\n\n\n<p><strong>Conclusions:<\/strong> Preventive actions to improve healthcare referral and coordination, especially for overweight and obese women and women with medical and obstetrical risk factors, could reduce perinatal mortality in disadvantaged areas.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Acta Obstet Gynecol Scand. 2020 Sep;99(9):1163-1173. doi: 10.1111\/aogs.13838. Epub 2020 Mar 29. PMID: 32155659.<br \/>\nFormat:<\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-3013","publication","type-publication","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Understanding high rates of stillbirth and neonatal death in a disadvantaged, high-migrant district in France: A perinatal audit. - FHU Prem&#039;IMPACT<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fhu-premimpact.org\/en\/publications\/understanding-high-rates-of-stillbirth-and-neonatal-death-in-a-disadvantaged-high-migrant-district-in-france-a-perinatal-audit\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Understanding high rates of stillbirth and neonatal death in a disadvantaged, high-migrant district in France: A perinatal audit. - FHU Prem&#039;IMPACT\" \/>\n<meta property=\"og:description\" content=\"Acta Obstet Gynecol Scand. 2020 Sep;99(9):1163-1173. doi: 10.1111\/aogs.13838. 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