14 results on '"Jarreau, Pierre-Henri"'
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2. Machine-Learning vs. Expert-Opinion Driven Logistic Regression Modelling for Predicting 30-Day Unplanned Rehospitalisation in Preterm Babies: A Prospective, Population-Based Study (EPIPAGE 2)
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Reed, Robert A., Morgan, Andrei S., Zeitlin, Jennifer, Jarreau, Pierre-Henri, Torchin, Héloïse, Pierrat, Véronique, Ancel, Pierre-Yves, and Khoshnood, Babak
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machine-learning ,rehospitalisation ,epidemiology ,prediction ,Pediatrics ,neonatology ,Original Research - Abstract
Introduction: Preterm babies are a vulnerable population that experience significant short and long-term morbidity. Rehospitalisations constitute an important, potentially modifiable adverse event in this population. Improving the ability of clinicians to identify those patients at the greatest risk of rehospitalisation has the potential to improve outcomes and reduce costs. Machine-learning algorithms can provide potentially advantageous methods of prediction compared to conventional approaches like logistic regression. Objective: To compare two machine-learning methods (least absolute shrinkage and selection operator (LASSO) and random forest) to expert-opinion driven logistic regression modelling for predicting unplanned rehospitalisation within 30 days in a large French cohort of preterm babies. Design, Setting and Participants: This study used data derived exclusively from the population-based prospective cohort study of French preterm babies, EPIPAGE 2. Only those babies discharged home alive and whose parents completed the 1-year survey were eligible for inclusion in our study. All predictive models used a binary outcome, denoting a baby's status for an unplanned rehospitalisation within 30 days of discharge. Predictors included those quantifying clinical, treatment, maternal and socio-demographic factors. The predictive abilities of models constructed using LASSO and random forest algorithms were compared with a traditional logistic regression model. The logistic regression model comprised 10 predictors, selected by expert clinicians, while the LASSO and random forest included 75 predictors. Performance measures were derived using 10-fold cross-validation. Performance was quantified using area under the receiver operator characteristic curve, sensitivity, specificity, Tjur's coefficient of determination and calibration measures. Results: The rate of 30-day unplanned rehospitalisation in the eligible population used to construct the models was 9.1% (95% CI 8.2–10.1) (350/3,841). The random forest model demonstrated both an improved AUROC (0.65; 95% CI 0.59–0.7; p = 0.03) and specificity vs. logistic regression (AUROC 0.57; 95% CI 0.51–0.62, p = 0.04). The LASSO performed similarly (AUROC 0.59; 95% CI 0.53–0.65; p = 0.68) to logistic regression. Conclusions: Compared to an expert-specified logistic regression model, random forest offered improved prediction of 30-day unplanned rehospitalisation in preterm babies. However, all models offered relatively low levels of predictive ability, regardless of modelling method.
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- 2021
3. Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in ten European regions
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Marques-Bonet, T., Cuttini, Marina, Piedvache, A., Boyle, Elaine M., Jarreau, Pierre Henri, Kollée, Louis A A, Maier, Rolf F., Milligan, David W A, van Reempts, P., Weber, Tom, Barros, Henrique, Gadzinowki, J., Draper, E. S., Zeitlin, Jennifer, Martens, E., Martens, Guy, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Pryds, Ole, Ancel, Pierre Yves, Blondel, Beatrice, Bréart, G., Gortner, Ludwig, Kuenzel, W., Misselwitz, Bjoern, Schmidt, S., Agostino, Rocco, DiLallo, D., Franco, Francesco, Paesano, R., Hukkelhoven, C., Hulscher, M., Koopman-Esseboom, C., van Heijst, A., Breborowicz, G., Gadzinowski, Janusz, Mazela, Jan, Carrapato, M., Ribeiro-Rodrigues, Teresa, Konje, J., Manktelow, B. N., Fenton, A. C., Sturgiss, S., and Mosaic EPICE Res Grp
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Male ,Pediatrics ,medicine.medical_specialty ,Maternal-Child Health Services ,medicine.medical_treatment ,Population ,Infant, Premature, Diseases ,03 medical and health sciences ,0302 clinical medicine ,McNemar's test ,Obstetrics and gynaecology ,Pregnancy ,030225 pediatrics ,Infant Mortality ,Obstetrics and Gynaecology ,neonatal intensive care ,Journal Article ,Humans ,Medicine ,Caesarean section ,Hospital Mortality ,030212 general & internal medicine ,education ,Ethics ,education.field_of_study ,Chi-Square Distribution ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Infant, Newborn ,Infant ,Obstetrics and Gynecology ,Gestational age ,extremely preterm births ,Delivery, Obstetric ,Organizational Policy ,3. Good health ,Europe ,Distress ,Logistic Models ,Infant, Extremely Premature ,Premature Birth ,Female ,Human medicine ,business ,Live birth ,Hospital Units ,Demography ,Cohort study - Abstract
Item does not contain fulltext OBJECTIVE: To investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTIs) between 2003 and 2012, and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: Population-based cohort studies in 2003 (MOSAIC study) and 2011/2012 (EPICE study) and questionnaires from hospitals. SETTING: 70 hospitals in ten European regions. POPULATION: Infants born at
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- 2017
4. Association of Short Antenatal Corticosteroid Administration-to-Birth Intervals With Survival and Morbidity Among Very Preterm Infants: Results From the EPICE Cohort
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Norman, Mikael, Piedvache, Aurelie, Børch, Klaus, Huusom, Lene Drasbek, Bonamy, Anna Karin Edstedt, Howell, Elizabeth A., Jarreau, Pierre Henri, Maier, Rolf F., Pryds, Ole, Toome, Liis, Varendi, Heili, Weber, Tom, Wilson, Emilija, van Heijst, Arno, Cuttini, Marina, Mazela, Jan, Barros, Henrique, Van Reempts, Patrick, Draper, Elizabeth S., Zeitlin, Jennifer, Martens, Evelyne, Martens, Guy, Hasselager, Asbjoern, Ancel, Pierre Yves, Blondel, Béatrice, Bonet, Mercedes, Burguet, Antoine, Truffert, Patrick, Misselwitz, Bjoern, Schmidt, Stephan, Gortner, Ludvig, Baronciani, Dante, Gargano, Giancarlo, Agostino, Rocco, DiLallo, Domenico, Franco, Francesco, Carnielli, Virgilio, Croci, Ileana, Koopman-Esseboom, Corrine, Nijman, Joppe, Gadzinowski, Janusz, Graça, Luís Mendes, Do Céu Machado, Maria, Rodrigues, Carina, Ribeiro-Rodrigues, Teresa, Boyle, Elaine M., Manktelow, Brad N., Fenton, Alan C., Effective Perinatal Intensive Care, Instituto de Saúde Pública, and EPICE Res Grp
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Male ,Pediatrics ,Infant, Premature, Diseases ,Cohort Studies ,0302 clinical medicine ,Pregnancy ,Infant Mortality ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,Original Investigation ,030219 obstetrics & reproductive medicine ,Gestational age ,Obstetrics and Gynecology ,Prenatal Care ,General Medicine ,Perinatology ,3. Good health ,Europe ,and Child Health ,Multicenter Study ,Obstetrics ,Premature birth ,Infant, Extremely Premature ,Necrotizing enterocolitis ,Female ,Infant, Premature ,Cohort study ,Antenatal corticosteroids ,medicine.medical_specialty ,Birth weight ,Gestational Age ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Birth Intervals ,030225 pediatrics ,Intensive care ,Journal Article ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,Neonatology ,Glucocorticoids ,business.industry ,Infant, Newborn ,Infant ,medicine.disease ,Pediatrics, Perinatology and Child Health ,Human medicine ,business - Abstract
Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown. Objective:To explore the associations between ANS administration-to-birth interval and survival and morbidity among very preterm infants. Design, Setting, and Participants: The Effective Perinatal Intensive Care in Europe (EPICE) study, a population-based prospective cohort study, gathered data from 19 regions in 11 European countries in 2011 and 2012 on 4594 singleton infants with gestational ages between 24 and 31 weeks, without severe anomalies and unexposed to repeated courses of ANS. Data were analyzed November 2016. Exposure: Time from first injection of ANS to delivery in hours and days. Main Outcomes and Measures: Three outcomes were studied: in-hospital mortality; a composite of mortality or severe neonatal morbidity, defined as an intraventricular hemorrhage grade of 3 or greater, cystic periventricular leukomalacia, surgical necrotizing enterocolitis, or stage 3 or greater retinopathy of prematurity; and severe neonatal brain injury, defined as an intraventricular hemorrhage grade of 3 or greater or cystic periventricular leukomalacia. Results: Of the 4594 infants included in the cohort, 2496 infants (54.3%) were boys, and the mean (SD) gestational age was 28.5 (2.2) weeks and mean (SD) birth weight was 1213 (400) g. Mortality for the 662 infants (14.4%) unexposed to ANS was 20.6% (136 of 661). Administration of ANS was associated with an immediate and rapid decline in mortality, reaching a plateau with more than 50% risk reduction after an administration-to-birth interval of 18 to 36 hours. A similar pattern for timing was seen for the composite mortality or morbidity outcome, whereas a significant risk reduction of severe neonatal brain injury was associated with longer administration-to-birth intervals (greater than 48 hours). For all outcomes, the risk reduction associated with ANS was transient, with increasing mortality and risk for severe neonatal brain injury associated with administration-to-birth intervals exceeding 1 week. Under the assumption of a causal relationship between timing of ANS and mortality, a simulation of ANS administered 3 hours before delivery to infants who did not receive ANS showed that their estimated decline in mortality would be 26%. Conclusions and Relevance:Antenatal corticosteroids may be effective even if given only hours before delivery. Therefore, the infants of pregnant women at risk of imminent preterm delivery may benefit from its use. The research received funding from grant agreement 259882 from the European Union Seventh Framework Program (2007-2013). Additional funding in France was provided by the French Institute of Public Health Research/Institute of Public Health and its partners, including the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer, and the National Solidarity Fund for Autonomy, by grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future, and by the PremUp Foundation; in Poland, by 2012-2015 allocation of funds for international projects from the Polish Ministry of Science and HigherEducation; and in Sweden, by regional agreementon medical training and clinical research betweenStockholm County Council and Karolinska Institutetand by the Department of Neonat al Medicine at theKarolinska University Hospital.
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- 2017
5. Parents’ expectations of staff in the early bonding process with their premature babies in the intensive care setting: a qualitative multicenter study with 60 parents
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Guillaume Sonia, Michelin Natacha, Amrani Elodie, Benier Brigitte, Durrmeyer Xavier, Lescure Sandra, Bony Charlotte, Danan Claude, Baud Olivier, Jarreau Pierre-Henri, Zana-Taïeb Elodie, and Caeymaex Laurence
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Prematurity ,Bond ,Child development ,Newborn ,NICU ,Nurses ,Family centered care ,Parenting ,Pediatrics ,RJ1-570 - Abstract
Abstract Background During the first weeks of hospitalization, premature babies and their parents encounter difficulties in establishing early bonds and interactions. Only a few studies have explored what caregivers can do to meet parents' needs in relation to these interactions and help optimize them. This study sought to explore parents' perception of these first interactions and to identify the actions of caregivers that help or hinder its development. Methods Prospective study, qualitative discourse analysis of 60 face-to-face interviews conducted with 30 mothers and 30 fathers of infants born before 32 weeks of gestation (mean ± SD: 27 ± 2 weeks of gestational age), during their child's stay in one out of three NICUs in France. Interviews explored parental experience, from before birth up to the first month of life. Results Data analysis uncovered two main themes, which were independent of parents' geographical or cultural origin but differed between mothers and fathers. First, fathers described the bond with their child as composed more of words and looks and involving distance, while mothers experienced the bond more physically. Secondly, two aspects of the caregivers' influence were decisive: nurses' caring attitude towards baby and parents, and their communication with parents, which reduced stress and made interactions with the baby possible. This communication appeared to be the locus of a supportive and fulfilling encounter between parents and caregivers that reinforced parents' perception of a developing bond. Conclusions At birth and during the first weeks in the NICU, the creation of a bond between mothers and fathers and their premature baby is rooted in their relationship with the caregivers. Nurses' caring attitude and regular communication adapted to specific needs are perceived by parents as necessary preconditions for parents' interaction and development of a bond with their baby. These results might allow NICU staff to provide better support to parents and facilitate the emergence of a feeling of parenthood.
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- 2013
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6. Lung microRNA deregulation associated with impaired alveolarization in rats after intrauterine growth restriction
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Dravet-Gounot, Pauline, Morin, Cécile, Jacques, Sébastien, Dumont, Florent, Ely-Marius, Fabiola, Vaiman, Daniel, Jarreau, Pierre-Henri, Méhats, Céline, and Zana-Taïeb, Elodie
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Male ,Lung Development ,Child Growth ,Microarrays ,Organogenesis ,lcsh:Medicine ,Research and Analysis Methods ,Real-Time Polymerase Chain Reaction ,Biochemistry ,Pediatrics ,Rats, Sprague-Dawley ,Child Development ,Cell Signaling ,Genetics ,Medicine and Health Sciences ,Animals ,lcsh:Science ,Non-coding RNA ,Nutrition ,Fetal Growth Retardation ,Biology and life sciences ,Protein Kinase Signaling Cascade ,Growth Restriction ,Gene Expression Profiling ,lcsh:R ,Cell Biology ,respiratory system ,Signaling Cascades ,Gene regulation ,Diet ,Rats ,Nucleic acids ,Pulmonary Alveoli ,MicroRNAs ,Bioassays and Physiological Analysis ,RNA ,lcsh:Q ,Female ,Gene expression ,Organism Development ,Research Article ,Signal Transduction ,Developmental Biology - Abstract
Intrauterine growth restriction (IUGR) was recently described as an independent risk factor of bronchopulmonary dysplasia, the main respiratory sequelae of preterm birth. We previously showed impaired alveolarization in rat pups born with IUGR induced by a low-protein diet (LPD) during gestation. We conducted a genome-wide analysis of gene expression and found the involvement of several pathways such as cell adhesion. Here, we describe our unbiased microRNA (miRNA) profiling by microarray assay and validation by qPCR at postnatal days 10 and 21 (P10 and P21) in lungs of rat pups with LPD-induced lung-alveolarization disorder after IUGR. We identified 13 miRNAs with more than two-fold differential expression between control lungs and LPD-induced IUGR lungs. Validated and predicted target genes of these miRNAs were related to "tissue repair" at P10 and "cellular communication regulation" at P21. We predicted the deregulation of several genes associated with these pathways. Especially, E2F3, a transcription factor involved in cell cycle control, was expressed in developing alveoli, and its mRNA and protein levels were significantly increased at P21 after IUGR. Hence, IUGR affects the expression of selected miRNAs during lung alveolarization. These results provide a basis for deciphering the mechanistic contributions of IUGR to impaired alveolarization.
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- 2017
7. Variation in term birth weight across European countries affects the prevalence of small for gestational age among very preterm infants
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Zeitlin, Jennifer, Bonamy, Anna Karin Edstedt, Piedvache, Aurelie, Cuttini, Marina, Barros, Henrique, Van Reempts, Patrick, Mazela, Jan, Jarreau, Pierre Henri, Gortner, Ludwig, Draper, Elizabeth S., Maier, Rolf F., Martens, E., Martens, Guy, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Pryds, Ole, Weber, Tom, Toome, Liis, Varendi, Heili, Ancel, Pierre Yves, Blondel, Beatrice, Burguet, Antoine, Truffert, P., Misselwitz, Bjoern, Schmidt, S., Baronciani, Dante, Gargano, G., Agostino, Rocco, DiLallo, D., Franco, Francesco, Carnielli, Virgilio, Koopman-Esseboom, C., van Heijst, A., Nijman, J., Gadzinowski, Janusz, Graça, Luis M., Ceu Machado, Maria, Carrapato, M. R.G., Ribeiro-Rodrigues, Teresa, Norman, Mikael, Wilson, E., Boyle, Elaine M., Manktelow, B. N., Fenton, A. C., Milligan, David W A, Marques-Bonet, T., Instituto de Saúde Pública, and EPICE Res Grp
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Male ,Percentile ,medicine.medical_specialty ,Birthweight ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intensive care ,Prevalence ,Journal Article ,medicine ,Birth Weight ,Humans ,Pediatrics, Perinatology, and Child Health ,reproductive and urinary physiology ,National data ,Fetal Growth Retardation ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Infant, Newborn ,Growth restriction ,General Medicine ,Intrauterine growth ,Small for gestational age ,medicine.disease ,Perinatology ,Europe ,and Child Health ,Very preterm ,Very preterm infants ,Intrauterine growth references ,Infant, Small for Gestational Age ,Pediatrics, Perinatology and Child Health ,Cohort ,Term Birth ,Gestation ,Female ,Human medicine ,business ,Infant, Premature - Abstract
Aim This study assessed the prevalence of small for gestational age (SGA) among very preterm (VPT) infants using national and European intrauterine references. Methods We generated country-specific and common European intrauterine growth references for 11 European countries, according to Gardosi's approach and Hadlock's fetal growth model, by using national data on birth weights by sex. These references were applied to the Effective Perinatal Intensive Care in Europe (EPICE) cohort, which comprised 7,766 live VPT births without severe congenital anomalies under 32 weeks of gestation in 2011-12, to estimate the prevalence of infants with SGA birth weights, namely those below the 10th percentile. Results The SGA prevalence was 31.8% with country-specific references and 34.0% with common European references. The European references yielded a 10-point difference in the SGA prevalence between countries with lower term birth weights (39.9%) - Portugal, Italy and France - and higher term birth weights, namely Denmark, Netherlands, Sweden (28.9%) (p
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- 2017
8. Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity
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Wilson, Emilija, Norman, Mikael, Maier, Rolf F., Misselwitz, Bjoern, Howell, Elizabeth A., Zeitlin, Jennifer, Bonamy, Anna Karin, Van Reempts, Patrick, Martens, Evelyne, Martens, Guy, Pryds, Ole, Boerch, Klaus, Hasselager, Asbjoern, Huusom, Lene, Weber, Tom, Toome, Liis, Varendi, Heili, Truffert, Patrick, Jarreau, Pierre Henri, Ancel, Pierre Yves, Blondel, Beatrice, Burguet, Antoine, Schmidt, Stephan, Gortner, Ludwig, Cuttini, Marina, Croci, Ileana, Baronciani, Dante, Gargano, Giancarlo, Carnielli, Virgilio, Di Lallo, Domenico, Agostino, Rocco, Franco, Francesco, Koopman-Esseboom, Corine, Nijman, Joppe, van Heijst, Arno, Gadzinowski, Janusz, Mazela, Jan, Graça, Luis M., Ceu Machado, Maria, Carapato, Rui, Barros, Henrique, Rodrigues, Carina, Rodrigues, Teresa, Draper, Elizabeth, Boyle, Elaine M., Manktelow, Brad, Milligan, David W A, and Fenton, Alan
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Male ,medicine.medical_specialty ,Pediatrics ,very preterm birth ,Observational Study ,Hypothermia ,Infant, Premature, Diseases ,Body Temperature ,03 medical and health sciences ,Patient Admission ,0302 clinical medicine ,Risk Factors ,Intensive Care Units, Neonatal ,030225 pediatrics ,Intensive care ,Epidemiology ,neonatal intensive care ,medicine ,Journal Article ,Humans ,Very Preterm Birth ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Pediatrics, Perinatology, and Child Health ,business.industry ,Incidence ,Infant, Newborn ,medicine.disease ,Perinatology ,Europe ,and Child Health ,Postnatal age ,Bronchopulmonary dysplasia ,Pediatrics, Perinatology and Child Health ,Cohort ,Necrotizing enterocolitis ,Linear Models ,Female ,epidemiology ,business ,Infant, Premature ,Follow-Up Studies ,Cohort study - Abstract
Objective To investigate the association between body temperature at admission to neonatal intensive care and in-hospital mortality in very preterm infants, stratified by postnatal age of death. Moreover, we assessed the association between admission temperature and neonatal morbidity. Study design In this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (
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- 2016
9. Early extubation is not associated with severe intraventricular hemorrhage in preterm infants born before 29 weeks of gestation. Results of an EPIPAGE-2 cohort study.
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Chevallier, Marie, Ancel, Pierre-Yves, Torchin, Héloïse, Marchand-Martin, Laetitia, Lorthe, Elsa, Truffert, Patrick, Jarreau, Pierre Henri, Roze, Jean Christophe, Pierrat, Véronique, Marret, Stéphane, Baud, Olivier, Benhammou, Valérie, Ego, Anne, and Debillon, Thierry
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PREMATURE infants ,INTRAVENTRICULAR hemorrhage ,COHORT analysis ,EXTUBATION ,GENERALIZED estimating equations ,PROPENSITY score matching - Abstract
Objective: To determine whether there is an association between severe intraventricular hemorrhage and early extubation in preterm infants born before 29 weeks of gestational age and intubated at birth. Methods: This study included 1587 preterm infants from a nationwide French population cohort (EPIPAGE-2). Secondary data on intubated preterm infants were analyzed. After gestational age and propensity score matching (1:1) we built two comparable groups: an early extubation group and a delayed extubation group. Each neonate in one group was paired with a neonate in the other group having the same propensity score and gestational age. Early extubation was defined as extubation within 48 hours of life. Severe intraventricular hemorrhages were defined as grade III or IV hemorrhages according to the Papile classification. Results: After matching, there were 398 neonates in each group. Using a generalized estimating equation model, we found that intraventricular hemorrhage was not associated with early extubation (adjusted OR 0.9, 95%CI 0.6–1.4). This result was supported by sensitivity analyses. Conclusion: The practice of early extubation was not associated with an increased proportion of intraventricular hemorrhages. To complete these results, the long-term neurologic outcomes of these infants need to be assessed. [ABSTRACT FROM AUTHOR]
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- 2019
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10. Effectiveness and efficiency of tele-expertise for improving access to retinopathy screening among 351 neonates in a secondary care center: An observational, controlled before-after study.
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Moitry, Marie, Zarca, Kevin, Granier, Michèle, Aubelle, Marie-Stéphanie, Charrier, Nathanaël, Vacherot, Brigitte, Caputo, Georges, Mimouni, Maroua, Jarreau, Pierre-Henri, and Durand-Zaleski, Isabelle
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RETROLENTAL fibroplasia ,RETINAL diseases ,OXYGEN therapy ,OPHTHALMOLOGISTS ,OPHTHALMOLOGY - Abstract
In France, secondary care hospitals encounter difficulties to adhere to retinopathy of prematurity (ROP) screening guidelines. Our objective was to assess the effectiveness and efficacy of a tele-expertise program for ROP screening in neonatal intensive care units without on-site ophthalmologists. We evaluated the impact of a tele-expertise program funded by the Paris Region Health Authority in a secondary care center general hospital of the Paris Region (CHSF), where there was previously no on-site ophthalmologist. We performed an observational, controlled before-after study, with a university tertiary care center with on-site ophthalmologists (Port-Royal) as the control group. Recruitment and data collection for both periods took place from 1 January 2012 to 31 December 31 2012, and from 1 January 2014 to 31 March 2015. The primary endpoint was the percentage of compliance with screening guidelines, secondary endpoints included pain scores and costs. Over the two periods, at total of 351 infants were recruited in the CHSF. Implementation of the tele-expertise resulted in an absolute +57.3% increase in the proportion of examinations realized in accordance with guidelines (3.8% during the "before" period and 61.1% during the "after" period, p<0.001). As compared with the control group, the proportion of infants appropriately screened improved (57.5% versus 43.1%, p = 0.002); median pain score on the acute pain rating scale for neonates during examination was significantly higher (median score 5.5/10, range [2.5–5.7] versus 2.0/10, range [1.0–3.1], p = 0.002). Screening rates in the control group remained unchanged. The average cost per examination increased from €337 in the "before" period to €353 in the "after period" in the tele-expertise group. The implementation of tele-expertise for ROP screening in the CHSF medical center resulted in a major improvement of access to care with a small cost increase. The issue of pain control during examination with tele-expertise should be further addressed. [ABSTRACT FROM AUTHOR]
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- 2018
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11. Survival and Morbidity of Preterm Children Born at 22 Through 34 Weeks’ Gestation in France in 2011
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Ancel , Pierre-Yves, Goffinet , François, Kuhn , Pierre, Langer , Bruno, Matis , Jacqueline, Hernandorena , Xavier, Chabanier , Pierre, Joly-Pedespan , Laurence, Lecomte , Bénédicte, Vendittelli , Françoise, Dreyfus , Michel, Guillois , Bernard, Burguet , Antoine, Sagot , Pierre, Sizun , Jacques, Beuchée , Alain, Rouget , Florence, Favreau , Amélie, Saliba , Elie, Bednarek , Nathalie, Morville , Patrice, Thiriez , Gérard, Marpeau , Loïc, Marret , Stéphane, Kayem , Gilles, Durrmeyer , Xavier, Granier , Michèle, Baud , Olivier, Jarreau , Pierre-Henri, Mitanchez , Delphine, Boileau , Pascal, Boulot , Pierre, Cambonie , Gilles, Daudé , Hubert, Bédu , Antoine, Mons , Fabienne, Fresson , Jeanne, Vieux , Rachel, Alberge , Corine, Alberge , Catherine, Arnaud , Catherine, Vayssière , Christophe, Truffert , Patrick, Pierrat , Véronique, Subtil , Damien, D'Ercole , Claude, Gire , Catherine, Simeoni , Umberto, Bongain , André, Sentilhes , Loïc, Rozé , Jean-Christophe, Gondry , Jean, Leke , André, Deiber , Michel, Claris , Olivier, Picaud , Jean-Charles, Ego , Anne, Debillon , Thierry, Poulichet , Anne, Coliné , Eliane, Favre , Anne, Fléchelles , Olivier, Samperiz , Sylvain, Ramful , Duksha, Branger , Bernard, Benhammou , Valérie, Foix-L'Hélias , Laurence, Marchand-Martin , Laetitia, Kaminski , Monique, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire d'Imagerie et de Neurosciences Cognitives ( LINC ), Université Louis Pasteur - Strasbourg I-IFR37-Centre National de la Recherche Scientifique ( CNRS ), Service de gynécologie–obstétrique, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre de compétences des microangiopathies thrombotiques, CHU Bordeaux [Bordeaux], pôle gynécologie-obstétrique et médecine foetale, Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement ( PEPRADE ), Université d'Auvergne - Clermont-Ferrand I ( UdA ) -CHU Clermont-Ferrand, Clinatec - Centre de recherche biomédicale Edmond J.Safra, Centre Hospitalier Universitaire [Grenoble] ( CHU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Gynécologie Obstétrique, Médecine Foetale et Stérilité Conjugale - Chirurgie Gynécologie et Oncologique [CHU de Dijon], Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Universitaire de Rennes, Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Physiologie de la reproduction et des comportements [Nouzilly] ( PRC ), Institut National de la Recherche Agronomique ( INRA ) -Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours-Centre National de la Recherche Scientifique ( CNRS ), Université de Reims Champagne-Ardenne ( URCA ), Service de cardiologie pédiatrique, Centre Hospitalier Universitaire de Reims ( CHU Reims ), Service Pédiatrique, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ), Service de gynécologie-obstétrique [Caen], CHU Caen, Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement ( Néovasc ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institute for Research and Innovation in Biomedicine ( IRIB ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Gynécologie-Obstétrique [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hopital Louis Mourier - AP-HP [Colombes], Médecine néonatale, Centre Hospitalier Sud Francilien, CH Evry-Corbeil-CH Evry-Corbeil, PremUp Foundation, Institut de Recherche pour le Développement ( IRD ) -Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Diderot - Paris 7 ( UPD7 ) -CHI Créteil-Université Paris Descartes - Paris 5 ( UPD5 ) -Sorbonne Universités-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maternité Port-Royal [CHU Cochin], Assistance Publique - Hôpitaux de Paris, Université Paris Descartes - Paris 5 ( UPD5 ), Gynéco-Obstétrique, Hôpital Arnaud de Villeneuve, Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] ( IBMM ), Ecole Nationale Supérieure de Chimie de Montpellier ( ENSCM ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Aix Marseille Université ( AMU ), Service de Pédiatrie médicale - réanimation et néonatologie [CHU Limoges], CHU Limoges, Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé, CCTIRS, Service d'Epidémiologie, Maternité Régionale Universitaire, Laboratoire Bordelais de Recherche en Informatique ( LaBRI ), Centre National de la Recherche Scientifique ( CNRS ) -École Nationale Supérieure d'Électronique, Informatique et Radiocommunications de Bordeaux (ENSEIRB)-Université Sciences et Technologies - Bordeaux 1-Université Bordeaux Segalen - Bordeaux 2, Epidémiologie et anlyses en santé publique: risques, maladies chroniques et handicaps, Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Unité de Néonatalogie, Hôpital Jeanne de Flandre [Lille], Unité de Recherche Epidémiologique sur la Qualité des Soins, Université de Lille, Droit et Santé, Service de Médecine Néonatale, Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service d'Obstétrique-Gynécologie [Marseille], Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille- Hôpital Nord [CHU - APHM], Vascular research center of Marseille ( VRCM ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Service de Gynécologie - Obstétrique, Reproduction et de Médecine f½tale, Université de la Méditerranée - Aix-Marseille 2, Service de gynécologie-obstétrique [Angers], CHU Angers, Santé Individu Société - SIS ( SIS ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Hospices Civils de Lyon ( HCL ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ), Registre des Handicaps de l'Enfant et Observatoire Périnatal Isère, RHEOP, DMIS, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Médecine Néonatale et Réanimation Pédiatrique CHU Grenoble, CHU Grenoble, Centre Hospitalier Félix-Guyon, Université de Maurice, CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I ( UdA ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Centre Hospitalier Universitaire [Grenoble] ( CHU ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Hôpital Charles Nicolle [Rouen], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon III ( UJML ) -Université Lumière - Lyon 2 ( UL2 )
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Pediatrics ,medicine.medical_specialty ,Population ,[ SDV.MHEP.PED ] Life Sciences [q-bio]/Human health and pathology/Pediatrics ,morbidity ,Infant, Premature, Diseases ,premature ,survival analysis ,Cohort Studies ,03 medical and health sciences ,birth ,0302 clinical medicine ,[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology ,030225 pediatrics ,Intensive care ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,gestational age ,education ,Prospective cohort study ,Survival rate ,Pregnancy ,education.field_of_study ,pregnancy outcome ,[ SDV ] Life Sciences [q-bio] ,business.industry ,Obstetrics ,Infant, Newborn ,premature birth ,medicine.disease ,infant ,infant mortality ,3. Good health ,Survival Rate ,Bronchopulmonary dysplasia ,Premature birth ,Pediatrics, Perinatology and Child Health ,Intensive Care, Neonatal ,Female ,France ,pregnancy ,business ,Infant, Premature ,Cohort study - Abstract
International audience; Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines. To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks' gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997. The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks' gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011. Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3). A total of 0.7% of infants born before 24 weeks' gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P
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- 2015
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12. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).
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Kneyber, Martin, Luca, Daniele, Calderini, Edoardo, Jarreau, Pierre-Henri, Javouhey, Etienne, Lopez-Herce, Jesus, Hammer, Jürg, Macrae, Duncan, Markhorst, Dick, Medina, Alberto, Pons-Odena, Marti, Racca, Fabrizio, Wolf, Gerhard, Biban, Paolo, Brierley, Joe, and Rimensberger, Peter
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RESPIRATORY insufficiency treatment ,ACUTE diseases ,LUNG injuries ,AIRWAY (Anatomy) ,ARTIFICIAL respiration ,CRITICAL care medicine ,INTENSIVE care units ,PATIENT monitoring ,PEDIATRICS ,RESPIRATORY measurements ,MECHANICAL ventilators ,SEVERITY of illness index ,THERAPEUTICS - Abstract
Purpose: Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children.Methods: The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method. An electronic literature search in PubMed and EMBASE was performed using a combination of medical subject heading terms and text words related to mechanical ventilation and disease-specific terms.Results: The Paediatric Mechanical Ventilation Consensus Conference (PEMVECC) consisted of a panel of 15 experts who developed and voted on 152 recommendations related to the following topics: (1) general recommendations, (2) monitoring, (3) targets of oxygenation and ventilation, (4) supportive measures, (5) weaning and extubation readiness, (6) normal lungs, (7) obstructive diseases, (8) restrictive diseases, (9) mixed diseases, (10) chronically ventilated patients, (11) cardiac patients and (12) lung hypoplasia syndromes. There were 142 (93.4%) recommendations with "strong agreement". The final iteration of the recommendations had none with equipoise or disagreement.Conclusions: These recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research. [ABSTRACT FROM AUTHOR]- Published
- 2017
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13. Evidence-Based Neonatal Unit Practices and Determinants of Postnatal Corticosteroid-Use in Preterm Births below 30 Weeks GA in Europe. A Population-Based Cohort Study.
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Nuytten, Alexandra, Behal, Hélène, Duhamel, Alain, Jarreau, Pierre-Henri, Mazela, Jan, Milligan, David, Gortner, Ludwig, Piedvache, Aurélie, Zeitlin, Jennifer, Truffert, Patrick, and null, null
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PREMATURE labor ,EVIDENCE-based medicine ,CORTICOSTEROIDS ,GESTATIONAL age ,WOMEN - Abstract
Background: Postnatal corticosteroids (PNC) were widely used to treat and prevent bronchopulmonary dysplasia in preterm infants until studies showed increased risk of cerebral palsy and neurodevelopmental impairment. We aimed to describe PNC use in Europe and evaluate the determinants of their use, including neonatal characteristics and adherence to evidence-based practices in neonatal intensive care units (NICUs). Methods: 3917/4096 (95,6%) infants born between 24 and 29 weeks gestational age in 19 regions of 11 European countries of the EPICE cohort we included. We examined neonatal characteristics associated with PNC use. The cohort was divided by tertiles of probability of PNC use determined by logistic regression analysis. We also evaluated the impact of the neonatal unit’s reported adherence to European recommendations for respiratory management and a stated policy of reduced PNC use. Results: PNC were prescribed for 545/3917 (13.9%) infants (regional range 3.1–49.4%) and for 29.7% of infants in the highest risk tertile (regional range 5.4–72.4%). After adjustment, independent predictors of PNC use were a low gestational age, small for gestational age, male sex, mechanical ventilation, use of non-steroidal anti-inflammatory drugs to treat persistent ductus arteriosus and region. A stated NICU policy reduced PNC use (odds ratio 0.29 [95% CI 0.17; 0.50]). Conclusion: PNC are frequently used in Europe, but with wide regional variation that was unexplained by neonatal characteristics. Even for infants at highest risk for PNC use, some regions only rarely prescribed PNC. A stated policy of reduced PNC use was associated with observed practice and is recommended. [ABSTRACT FROM AUTHOR]
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- 2017
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14. Risk factors for not delivering in a level III unit before 32 weeks of gestation: results from a population-based study in Paris and surrounding districts in 2003.
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Zeitlin, Jennifer, Gwanfogbe, Cletus D., Delmas, Dominique, Pilkington, Hugo, Jarreau, Pierre-Henri, Chabernaud, Jean-Louis, Bréart, Gérard, and Papiernik, Emile
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PREGNANCY ,NEONATAL intensive care ,PEDIATRICS ,CRITICAL care medicine ,INFANT health services ,HOSPITAL care of newborn infants - Abstract
Delivery of very preterm babies in maternity units with on-site neonatal intensive care (level III units) is associated with lower mortality and morbidity. This analysis explores risk factors for not delivering in a level III unit, using data from a population-based study of very preterm births in Paris and surrounding districts in 2003. The sample for analysis included resident women with a fetus alive at the onset of labour between 24 and 31 weeks of gestation ( n = 641). Characteristics of women delivering in and those not in level III units were compared using logistic regression. Further analysis was carried out for the subgroup of women not already scheduled to deliver in a level III unit. Twenty-nine per cent of women did not deliver in level III units; in the subgroup scheduled to deliver in level I or II units, 43% were not transferred. Women were less likely to deliver in a level III unit if they had a singleton pregnancy, a gestation of <26 weeks or at 31 weeks, experienced antenatal haemorrhaging, lived in socially deprived neighbourhoods or at a greater distance from the nearest level III. Women scheduled to deliver in a maternity unit with a special care nursery were also less likely to deliver in a level III unit. In contrast, preterm rupture of membranes and fetal growth restriction increased the likelihood of a level III delivery. These results underline the importance of controlling for clinical characteristics when analysing perinatal outcome by place of delivery and show how socioe-conomic factors, known to impact on the risk of having a preterm birth, can also affect access to appropriate care. [ABSTRACT FROM AUTHOR]
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- 2008
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