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  1. Article ; Online: Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study

    Françoise Vendittelli / Chloé Barasinski / Olivier Rivière / Caroline Da Costa Correia / Catherine Crenn-Hébert / Michel Dreyfus / Anne Legrand / Laurent Gerbaud

    Healthcare, Vol 10, Iss 992, p

    2022  Volume 992

    Abstract: Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units ... ...

    Abstract Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units according to the quality of their PPH protocol. We used a mixed design, a prospective cohort (3442 women with PPH after vaginal delivery; February–July 2011), and an audit of the written protocols (177 French maternity units; September 2010–June 2011). A quality score was calculated for the protocol of each unit. Maternity units were classified into three categories according to this score: category 1 (total score: 0–8), category 2 (9–12.5), and category 3 (>12.5). The PPH incidence (>500 mL) was 3.2%, 3.3% and 4.6% among maternity units in categories 1, 2 and 3, respectively ( p < 0.0001). The incidence of severe maternal morbidity (surgery and/or artery embolization and/or blood transfusion) was higher among maternity units in category 1 (54.8%; 95% CI: 51.9, 57.7) than in either category 2 (50.1%; 95% CI: 47.8, 52.5) or 3 (38.0%; 95% CI: 33.8, 42.4]) ( p < 0.0001). The risks of severe maternal morbidity were lower for category 3 than category 1 and 2 (respectively, adjusted RR 0.68, 95% CI 0.60–0.86 and 0.77, 95% CI 0.68–0.87). Finally, maternity units with higher scores identified PPH better and used fewer curative second-line procedures.
    Keywords blood transfusion ; clinical practice guidelines ; postpartum hemorrhage ; protocol ; severe maternal morbidity ; vaginal delivery ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Mental health of pregnant women during the SARS-CoV-2 pandemic in France

    Alexandra Doncarli / Lucia Araujo-Chaveron / Catherine Crenn-Hebert / Marie-Noëlle Vacheron / Christophe Léon / Imane Khireddine / Francis Chin / Alexandra Benachi / Sarah Tebeka / Nolwenn Regnault

    PLoS ONE, Vol 18, Iss

    Evolution of self-perceived psychological state during the first lockdown, and anxiety frequency two months after the lockdown ended

    2023  Volume 4

    Abstract: Previous pandemics and related lockdowns have had a deleterious impact on pregnant women’s mental health. We studied the impact of the SARS-CoV-2/Covid-19 pandemic and France’s first lockdown on pregnant women’s mental health. A cross-sectional study was ...

    Abstract Previous pandemics and related lockdowns have had a deleterious impact on pregnant women’s mental health. We studied the impact of the SARS-CoV-2/Covid-19 pandemic and France’s first lockdown on pregnant women’s mental health. A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 adult women who were pregnant during the first lockdown in France (March-May 2020). Questions focused on their self-perceived psychological state and affects they felt before and during the lockdown and anxiety symptomatology (HAD) two months after it ended. A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPR) for anxiety and self-perceived psychological state evolution. One in five respondents (21.1%) reported psychological deterioration during lockdown. Associated determinants were: i) little or no social support (self-perceived) (aRP = 1.77, 95%CI[1.18–2.66]), ii) increased workload (1.65, [1.02–2.66]), and iii) poor/moderate knowledge about SARS-CoV-2 transmission (1.60, [1.09–2.35]). Seven percent of women reporting psychological deterioration had access to professional psychological support during lockdown, while 19% did not despite wanting it. Women reported heightened powerlessness (60.3%), frustration (64%) and fear (59.2%) during lockdown. One in seven respondents (14.2%, 95%CI[10.9–18.2]) had anxiety symptoms. Determinants associated: i) at least one pregnancy-related pathology (aPR = 1.82, 95%CI[1.15–2.88]), ii) overweightness or obesity (1.61, [1.07–2.43]), iii) one child under the age of six years in the household during the lockdown (3.26, [1.24–8.53]), iv) little or no social support (self-perceived) during the lockdown (1.66, [1.07–2.58]), v) friend or relatives diagnosed with Covid-19 or with symptoms of the disease (1.66; [1.06–2.60]), vi) no access to medication for psychological distress (2.86, [1.74–4.71]), and vii) unsuccessfully seeking exchanges with healthcare professionals about their pregnancy during the pandemic (1.66, ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 150
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Impact of the 1st Wave of the COVID-19 Pandemic and Lockdown on In Utero Transfer Activity in the Paris Area, France

    Alexandre J. Vivanti / Stanislas Fesquet / Diane Gabriel / Alexandra Letourneau / Catherine Crenn-Hebert / Daniele De Luca / Jean Bouyer / Sophie Novelli / Alexandra Benachi / Raphaël Veil

    Journal of Clinical Medicine, Vol 11, Iss 16, p

    2022  Volume 4850

    Abstract: Background: To assess changes in the number and profile of in utero transfer requests during the first lockdown. Methods: An observational, retrospective, cohort study. All pregnant women, from the Paris area (France), for whom a request for in utero ... ...

    Abstract Background: To assess changes in the number and profile of in utero transfer requests during the first lockdown. Methods: An observational, retrospective, cohort study. All pregnant women, from the Paris area (France), for whom a request for in utero transfer to the transfer unit was made during the first lockdown in France (from 17 March to 10 May 2020) or during a mirror period (years 2016 to 2019) were included. We compared the numbers and proportions of various indications for in utero transfer, the rates of in utero transfer acceptance and the proportion of outborn deliveries. Results: 206 transfer requests were made during the lockdown versus 227, 236, 204 and 228 in 2016, 2017, 2018 and 2019, respectively. The relative proportion of requests for threatened preterm births and for fetal growth restriction decreased from 45% in the mirror period to 37% and from 8 to 3%, respectively. The transfer acceptance rates and outborn deliveries did not differ between time periods. Conclusions: Although a reduction in in utero transfer requests was observed for certain indications, the first lockdown was not associated with a decrease in acceptance rates nor in an increase in outborn births of pregnancies with a high risk of prematurity in the Paris area.
    Keywords COVID-19 ; in utero transfer ; preterm delivery ; lockdown ; Medicine ; R
    Subject code 900
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Pregnant women's unmet need to communicate with a health professional during the SARS-CoV-2 pandemic lockdown in France

    Lucia Araujo-Chaveron / Alexandra Doncarli / Catherine Crenn-Hebert / Virginie Demiguel / Julie Boudet-Berquier / Yaya Barry / Maria-Eugênia Gomes Do Espirito Santo / Andréa Guajardo-Villar / Claudie Menguy / Anouk Tabaï / Karine Wyndels / Alexandra Benachi / Nolwenn Regnault

    PLoS ONE, Vol 17, Iss 4, p e

    The Covimater cross-sectional study.

    2022  Volume 0266996

    Abstract: During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic lockdown, communication between pregnant women and health professionals may have become complicated due to restrictions on movement and saturated health services. This could ...

    Abstract During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic lockdown, communication between pregnant women and health professionals may have become complicated due to restrictions on movement and saturated health services. This could have impacts on pregnancy monitoring and women's wellbeing. We aimed to i) describe the unmet need of pregnant women living in France to communicate with health professionals about the pandemic and their pregnancy during the lockdown, ii) assess the socio-demographic, medical and contextual factors associated with this unmet need. The Covimater cross-sectional study, conducted in July 2020, includes data on 500 adult women's experiences of pregnancy during the first lockdown period in France (i.e., from March to May 2020). The women, all residents in metropolitan France, answered a web-based questionnaire about their conversations with health professionals during the lockdown, as well as their social and medical characteristics. A robust variance Poisson regression model was used to estimate crude or adjusted prevalence ratios (aPRs) for their unmet need to communicate with health professionals about the pandemic and their pregnancy. Forty-one percent of participants reported an unmet need to communicate with a health professional during the lockdown, mainly about the risk of transmitting SARS-CoV-2 to their baby and the consequences for the latter. Factors associated were: i) being professionally inactive (aPR = 1.58,CI95%[(1.14-2.21]), ii) having an educational level below secondary school diploma (1.38,[1.05,-1.81]), iii) having experienced serious arguments/violence (2.12,[1.28-3.52]), iv) being very worried about the pandemic (1.41,[1.11-1.78]), v) being primiparous (1.36,[1.06-1.74]) and vi) having had pregnancy consultations postponed/cancelled by health professionals during the lockdown (1.35,[1.06-1.73]). These results can be used to develop targeted strategies that ensure pregnant women are able to i) communicate with health professionals about the ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 360 ; 300
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Women and health professionals’ perspectives on a conditional cash transfer programme to improve pregnancy follow-up

    Celine Chauleur / Jacob Hannigsberg / Philippe Merviel / Marc Bardou / Franck Perrotin / Thomas Schmitz / Olivier Picone / Jeanne Sibiude / Karine Chemin / Dominique Dallay / Frédéric Coatleven / Loïc Sentilhes / Céline Brochot / Astrid Eckman-Lacroix / Elise Thellier / Frédérique Falchier / Philippe Deruelle / Muriel Doret / Xavier Carcopino-Tusoli /
    Nicolas Meunier-Beillard / Hervé Fernandez / Vincent Villefranque / Caroline Diguisto / Damien Subtil / Clémence Houssin / Philippe Gillard / Laurent Mandelbrot / Aurelie Godard-Marceau / Nathalie Lesavre / Claude Virtos / Elodie Debras / Aude Bourtembourg / Claire Toubin / Danièle Addes / Véronique Uguen / Cleo Tourbot / Caroline Lelievre / Christophe Tremouilhac / Anne-Hélène Saliou / Aurelie Derrieu / Stephanie Auget / Anne Legourrierec / Anne Leroux / Julie Fort-Jacquier / Marion Serclerat / Nathalie Laurenceau / Audrey Renouleau / Eliane Catteau / Julie Blanc / Candice Ronin / Laurence Piechon / Séverine Puppo / Fanny Greco / Sandrine Pettazzoni / Muriel Athlani / Amina Desvignes / Annie Petiteau / Amina El Yaakoubi / Valérie Bechadergue / Valérie Vaugirard / Marie-Emmanuelle Neveu / Caroline Geyl / Marie-Victoire Senat / Claire Colmant / Marie Houllier / Myriam Virlouet / Marion Mir / Yasmina Bejaoui / Hélène Le Cornu / Lauriane Nikel / Elodie Gustave / Amandine Stadler / Ahmad Mehdi / Tiphaine Barjat / Suzanne Lima / Thomas Corsini / Anne Genod / Charlotte Vermesch / Cécile Fanget / Marianne Perrot / Manuela Munoz / Sylvie Pitaval / Fanny Magand / Françoise Baldi / Stephanie Bret / Anne-Lise Verdier / Christelle Denis / Carine Arlicot / Jérôme Potin / Stéphanie Chretien / Julie Paternotte / Nathalie Trignol / Élisabeth Blin / Camille Mathieu / Anne Dubreuil / Anne Viallon Pelletier / Catherine Guerin / Chloé Arthuis / Christophe Vayssieres / Olivier Parant / Marion Groussolles / Maria Denis / M Mathieu Morin / Marie-Thérèse Bavoux / Juliette Pelloux / Anne-Claire Jambon / Madeleine Santraine / Veronique Lebuffe / Pascale Broux / Thierry Dzukou / Magloire Gnansounou / Didier Hubert / Claire Djazet / Ludivine Destoop / Marine Derue / Pierrick Theret / Dominique Delzenne / Stéphanie Daussin / Alice Fraissinet / Mélanie Vannerum / Cyril Faraguet / Laurence Landais / Mariana Radu / Anne Rouget / Sena Al Sudani / Bernard Guillon / Estelle Wucher / Véronique Selva / Sandrine Reviron / Francis Schwetterlé / Cécile Chassande / Véronique Grandin / Eliane Krtoliza / Patrick Becher / Marie Sarrau / Claire Lecoq / Elsa Lutringer / Denis Roux / Noémie Berge / Clémentine Barbier / Anne Heron / Audrey Farina-Bracquart / Marie-Paule Curtet / Evelyne Lefebure / Marie-Hélène Le Douarin / Hassan Al Rayes / Émilie Magne / Nathalie Destampes / Émilie Ricard / Pascale Ghezzi / Catherine Guillen / Fanny Alazard / Marie-Thé Campanaro / Florence Mojard / Magalie David-Reynard / Patricia Fuma / Remy De Montgolfier / Capucine Neel / Guillaume Legendre / Isabelle Andre / Sylvie Nordstrom / Brigitte Guionnet / Catherine Crenn Hebert / Chloé Dussaux / Karine Achaintre / Anne Wagner / Martine Werveake / Eloïse De Gouville / George Theresin / Marie Pierre Couetoux / Lydia Caillaud / Marie-Pierre Fernandez / Sabrina Bottet / M Alain Almodovar / Elisa Etienne / Véronique Guiteras / Angélique Torres / N. Roche / Myriam Nassef / Christine Abel-Faure / Marie Louvet / Carole Ettori / Guillaume Ducarme / Valérie Bonnenfant-Mezeray / Laurence Szezot-Renaudeau / Marie-Pierre Berte / Elodie Netier-Herault / Stéphanie Manson-Gallone / Franck Mauviel / Nathalie Agostini / Marine Mazeaud / Jean-Claude Dausset / Isabelle De Murcia / Emilie Alliot / Anne-Marie Bes / Magali Biferi Magali / Hélène Heckenroth / Sophie Morange / Gersende Chiuot / Audrey Gnisci / Annie Allegre / Laetitia Lecq / Eva Balenbois / Claire Tourette / Aude Figarella / Dio Andriamanjay / Pauline Vignoles / Catherine Cazelles / Véronique Lejeune Saada / Benafsheh Kashani / Isabelle Chevalier / Muriel Terrieres / Audrey Cointement / Valérie Benhaïm / Najat Lindoune / Anne-Sophie Maisonneuve / M Frédéric Daubercy / Guilia Mencattini / Vanessa Combaud / Isabelle Moya / Xavier-Côme Donato / Raoul Desbriere / Marie Lafon / Véronique Baudet

    BMJ Open, Vol 13, Iss

    a qualitative analysis of the NAITRE randomised controlled study

    2023  Volume 3

    Abstract: Objectives Women of low socioeconomic status have been described as having suboptimal prenatal care, which in turn has been associated with poor pregnancy outcomes. Many types of conditional cash transfer (CCT) programmes have been developed, including ... ...

    Abstract Objectives Women of low socioeconomic status have been described as having suboptimal prenatal care, which in turn has been associated with poor pregnancy outcomes. Many types of conditional cash transfer (CCT) programmes have been developed, including programmes to improve prenatal care or smoking cessation during pregnancy, and their effects demonstrated. However, ethical critiques have included paternalism and lack of informed choice. Our objective was to determine if women and healthcare professionals (HPs) shared these concerns.Design Prospective qualitative research.Setting We included economically disadvantaged women, as defined by health insurance data, who participated in the French NAITRE randomised trial assessing a CCT programme during prenatal follow-up to improve pregnancy outcomes. The HP worked in some maternities participating in this trial.Participants 26 women, 14 who received CCT and 12 who did not, mostly unemployed (20/26), and - 7 HPs.Interventions We conducted a multicentre cross-sectional qualitative study among women and HPs who participated in the NAITRE Study to assess their views on CCT. The women were interviewed after childbirth.Results Women did not perceive CCT negatively. They did not mention feeling stigmatised. They described CCT as a significant source of aid for women with limited financial resources. HP described the CCT in less positive terms, for example, expressing concern about discussing cash transfer at their first medical consultation with women. Though they emphasised ethical concerns about the basis of the trial, they recognised the importance of evaluating CCT.Conclusions In France, a high-income country where prenatal follow-up is free, HPs were concerned that the CCT programme would change their relationship with patients and wondered if it was the best use of funding. However, women who received a cash incentive said they did not feel stigmatised and indicated that these payments helped them prepare for their baby’s birth.Trial registration number NCT02402855
    Keywords Medicine ; R
    Subject code 300
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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