E. Papiernik et Lg. Keith, THE REGIONALIZATION OF PERINATAL-CARE IN FRANCE - DESCRIPTION OF A MISSING POLICY, European journal of obstetrics, gynecology, and reproductive biology, 61(2), 1995, pp. 99-103
This paper reviews published data on the organization and evaluation o
f regionalized perinatal care programs in countries where they exist a
nd describes those elements presently lacking in France. The advantage
of maternal compared to neonatal transport is described vis-85-vis it
s effect on perinatal deaths as well as neonatal and developmental han
dicaps, Most studies describe a major advantage of maternal transfers,
with less perinatal deaths (including stillbirths and neonatal deaths
) and lower rates of severe developmental handicaps, In contrast, Fren
ch publications show that widespread regionalization of perinatal care
does not exist in spite of proposals advocating this concept made mor
e than 20 years ago. Thus, many deliveries of less than 33 weeks gesta
tion length or/and less than 1500 g birthweight take place in maternit
y sites without adequate neonatal care, despite ample evidence that su
ch infants are at much greater risk of perinatal death or severe handi
caps at 2 years of age after transfer than if they had been born in a
perinatal center, For these reasons, professional organizations in Fra
nce should choose to implement a policy of maternal transfers as a maj
or effort in the near future.