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Article: Change in Hemoglobin Was Not a Reliable Diagnostic Screening Test for Postpartum Hemorrhage: A French Prospective Multicenter Cohort Study (HERA Study).

Barasinski, Chloé / Pranal, Marine / Léger, Stéphanie / Debost-Legrand, Anne / Vendittelli, Françoise

2023 Volume 11, Issue 8

Abstract: Changes between pre- and postpartum hemoglobin might be useful for optimizing the postpartum diagnosis of postpartum hemorrhage (PPH), defined as a blood loss exceeding 500 mL. This study's principal objective was to estimate the mean change in ... ...

Abstract	Changes between pre- and postpartum hemoglobin might be useful for optimizing the postpartum diagnosis of postpartum hemorrhage (PPH), defined as a blood loss exceeding 500 mL. This study's principal objective was to estimate the mean change in hemoglobin (between pre/post-delivery hemoglobin) among women with vaginal deliveries and PPH. The secondary objectives were to analyze: hemoglobin changes according to blood volume loss, the appropriateness of standard thresholds for assessing hemoglobin loss, and the intrinsic and extrinsic performances of these threshold values for identifying PPH. French maternity units (
Language	English
Publishing date	2023-04-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare11081111
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Article: Workplace Lactation Support: A Cross-Sectional Study in a University Hospital and a Perinatal Network

Barasinski, Chloé / Stankovic, Marina / Debost-Legrand, Anne / Delabaere, Amélie / Vendittelli, Françoise / Dutheil, Frédéric

Nutrients. 2022 Aug. 24, v. 14, no. 17

2022

Abstract: Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the ... ...

Abstract	Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the arrangements for facilitating the continuation of breastfeeding on return to work at all departments at the Clermont-Ferrand University Hospital Center and perinatal (obstetric and pediatric) departments in this region. Our principal endpoint was the percentage of departments reporting that they had a lactation room—a room where nursing mothers can express milk—and whether it met the criteria defined by the French Labor Code. Among 98 respondents, 44 departments (44.9%) did not offer lactation rooms; of the remaining 54 departments, only 11 rooms met the legal requirements. All perinatal departments offered lactation rooms. The availability of a lactation room was associated with other breastfeeding support, such as a break period for expressing milk (p < 0.0001) and the availability of a refrigerator to store it (p = 0.01). Almost half the responding departments did not offer a lactation room where mothers could breastfeed or pump their milk. Measures must be envisioned to facilitate the pumping of breast milk by French women returning to work.
Keywords	breast feeding ; breast milk ; cross-sectional studies ; hospitals ; labor ; lactation ; milk ; refrigerators ; working conditions ; France
Language	English
Dates of publication	2022-0824
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14173463
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Article ; Online: Is directed open-glottis pushing more effective than directed closed-glottis pushing during the second stage of labor? A pragmatic randomized trial - the EOLE study.

Barasinski, Chloé / Debost-Legrand, Anne / Vendittelli, Françoise

Midwifery

2020 Volume 91, Page(s) 102843

Abstract: Objective: To compare the effectiveness of directed open-glottis and directed closed-glottis pushing.: Design: Pragmatic, randomised, controlled, non-blinded superiority study.: Settings: Four French hospitals between July 2015 and June 2017 (2 ... ...

Abstract	Objective: To compare the effectiveness of directed open-glottis and directed closed-glottis pushing. Design: Pragmatic, randomised, controlled, non-blinded superiority study. Settings: Four French hospitals between July 2015 and June 2017 (2 academic hospitals and 2 general hospitals). Participants: 250 women in labour who had undergone standardised training in the two types of pushing with a singleton fetus in cephalic presentation at term (≥37 weeks) were included by midwives and randomised; 125 were allocated to each group. The exclusion criteria were previous caesarean birth or fetal heart rate anomaly. Participants were randomised during labour, after a cervical dilation ≥ 7 cm. Interventions: In the intervention group, open-glottis pushing was defined as a prolonged exhalation contracting the abdominal muscles (pulling the stomach in) to help move the fetus down the birth canal. Closed-glottis pushing was defined as Valsalva pushing. Measurements: The principal outcome was "effectiveness of pushing" defined as a spontaneous birth without any episiotomy, second-, third-, or fourth-degree perineal lesion. The results in our intention-to-treat analysis are reported as crude relative risks (RR) with their 95% confidence intervals. A multivariable analysis was used to take the relevant prognostic and confounding factors into account and obtain an adjusted relative risk (aRR). Findings: In our intention-to-treat analysis, most characteristics were similar across groups including epidural analgesia (>95% in each group). The mean duration of the expulsion phase was longer among the open-glottis group (24.4 min ± 17.4 vs. 18.0 min ± 15.0, p=0.002). The two groups did not appear to differ in the effectiveness of their pushing (48.0% in the open-glottis group versus 55.2% in the closed-glottis group, for an adjusted relative risk (aRR) of 0.92, 95% confidence interval (CI) 0.74-1.14) or in their risk of instrumental birth (aRR 0.97, 95%CI 0.85-1.10). Key conclusions: In maternity units with a high rate of epidural analgesia, the effectiveness of the type of directed pushing does not appear to differ between the open- and closed-glottis groups. Implications for practice: If directed pushing is necessary, women should be able to choose the type of directed pushing they prefer to use during birth. Professionals must therefore be trained in both types so that they can adequately support women as they give birth.
MeSH term(s)	Adult ; Breathing Exercises/methods ; Breathing Exercises/standards ; Breathing Exercises/statistics & numerical data ; Delivery, Obstetric/methods ; Delivery, Obstetric/standards ; Delivery, Obstetric/statistics & numerical data ; Female ; France ; Glottis/physiology ; Humans ; Labor Stage, Second/physiology ; Pregnancy
Language	English
Publishing date	2020-09-22
Publishing country	Scotland
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	1036567-9
ISSN	1532-3099 ; 0266-6138
ISSN (online)	1532-3099
ISSN	0266-6138
DOI	10.1016/j.midw.2020.102843
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Article ; Online: Workplace Lactation Support: A Cross-Sectional Study in a University Hospital and a Perinatal Network.

Barasinski, Chloé / Stankovic, Marina / Debost-Legrand, Anne / Delabaere, Amélie / Vendittelli, Françoise / Dutheil, Frédéric

Nutrients

2022 Volume 14, Issue 17

Abstract	Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the arrangements for facilitating the continuation of breastfeeding on return to work at all departments at the Clermont-Ferrand University Hospital Center and perinatal (obstetric and pediatric) departments in this region. Our principal endpoint was the percentage of departments reporting that they had a lactation room—a room where nursing mothers can express milk—and whether it met the criteria defined by the French Labor Code. Among 98 respondents, 44 departments (44.9%) did not offer lactation rooms; of the remaining 54 departments, only 11 rooms met the legal requirements. All perinatal departments offered lactation rooms. The availability of a lactation room was associated with other breastfeeding support, such as a break period for expressing milk (p < 0.0001) and the availability of a refrigerator to store it (p = 0.01). Almost half the responding departments did not offer a lactation room where mothers could breastfeed or pump their milk. Measures must be envisioned to facilitate the pumping of breast milk by French women returning to work.
MeSH term(s)	Breast Feeding ; Child ; Cross-Sectional Studies ; Female ; Hospitals ; Humans ; Lactation ; Mothers ; Pregnancy ; Social Support ; Women, Working ; Workplace
Language	English
Publishing date	2022-08-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14173463
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Article ; Online: Does the type of pushing at delivery influence pelvic floor function at 2 months postpartum? A pragmatic randomized trial-The EOLE study.

Barasinski, Chloé / Debost-Legrand, Anne / Savary, Denis / Bouchet, Pamela / Curinier, Sandra / Vendittelli, Françoise

Acta obstetricia et gynecologica Scandinavica

2022

Abstract: Introduction: Maternal pushing techniques during the second stage of labor may affect women's pelvic floor function. Our main objective was to assess the impact of the type of pushing used at delivery on the mother's medium-term pelvic floor function.!## ...

Abstract	Introduction: Maternal pushing techniques during the second stage of labor may affect women's pelvic floor function. Our main objective was to assess the impact of the type of pushing used at delivery on the mother's medium-term pelvic floor function. Material and methods: This is a secondary analysis of a randomized clinical trial (clinicaltrials.gov: NCT02474745) that took place in four French hospitals from 2015 through 2017 (n = 250). Women in labor with a singleton fetus in cephalic presentation at term who had undergone standardized training in both of these types of pushing were randomized after cervical dilation ≥7 cm. The exclusion criteria were a previous cesarean, a cesarean delivery in this pregnancy or a fetal heart rate anomaly. In the intervention group, open-glottis (OG) pushing was defined as a prolonged exhalation contracting the abdominal muscles to help move the fetus down the birth canal. Closed-glottis (CG) pushing was defined as Valsalva pushing. The principal outcome was the stage of pelvic organ prolapse (POP) assessed by the Pelvic Organ Prolapse-Quantification 2 months after delivery. A secondary outcome was incidence of urinary incontinence (UI). The results of our multivariable, modified intention-to-treat analysis are reported as crude relative risks (RRs) with their 95% confidence intervals. Results: Our analysis included 207 women. Mode of birth was similar in both groups. The two groups did not differ for stage II POP: 10 of 104 (9.4%) in the OG group compared with 7 of 98 (7.1%) in the CG group, for a RR 1.32, 95% confidence interval [CI] 0.52-3.33, and an adjusted RR of 1.22, 95% CI 0.42-3.6. Similarly, the incidence of UI did not differ: 26.7% in the OG group and 28.6% in the CG group (aRR 0.81, 95% CI 0.42-1.53). Subgroup analysis suggests that for secundiparous and multiparous women, OG pushing could have a protective effect on the occurrence of UI (RR 0.33, 95% CI 0.13-0.80). Conclusions: The type of directed pushing used at delivery did not impact the occurrence of pelvic organ prolapse 2 months after delivery. OG pushing may have a protective effect against UI among secundiparous and multiparous women.
Language	English
Publishing date	2022-11-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80019-3
ISSN	1600-0412 ; 0001-6349
ISSN (online)	1600-0412
ISSN	0001-6349
DOI	10.1111/aogs.14461
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Article ; Online: Opti'care protocol: a randomised control trial to evaluate the impact of a mobile antenatal care clinic in isolated rural areas on prenatal follow-up.

Debost-Legrand, Anne / Legrand, Guillaume / Duclos-Médard, Julie / Thomazet, Juliette / Pranal, Marine / Langlois, Eric / Mourgues, Charline / Vendittelli, Françoise

BMJ open

2023 Volume 13, Issue 2, Page(s) e060337

Abstract: Introduction: Rural residence appears to be a factor of vulnerability among pregnant women with poor clinical antenatal care. Our principal objective is to assess the impact of an infrastructure for a mobile antenatal care clinic on the completion of ... ...

Abstract	Introduction: Rural residence appears to be a factor of vulnerability among pregnant women with poor clinical antenatal care. Our principal objective is to assess the impact of an infrastructure for a mobile antenatal care clinic on the completion of antenatal care for women identified as geographically vulnerable in a perinatal network. Methods and analysis: Controlled cluster-randomised study in two parallel arms comparing an intervention group with an open-label control group. This study will concern the population of pregnant women who must live in one of the municipalities covered by the perinatal network and considered to be an area of geographic vulnerability. The cluster randomisation will take place according to the municipality of residence. The intervention will be the implementation of pregnancy monitoring by a mobile antenatal care clinic. The completion of antenatal care between the intervention and control groups will be a binary criterion: 1 will be attributed to each antenatal care that includes all visits and supplementary examinations. Sample size has been estimated to be 330 at least with an 80% participation rate.The univariate analyses will compare the follow-up rates (with Fisher's exact test), and all individual characteristics collected (Fisher's exact test, Student's t-test) between the two groups. The multivariate analysis will use a mixed linear model analysis and consider the cluster effect as random; the initial model will include known confounders from the literature, confounders identified in univariate analyses, and the clinically relevant prognostic factors. All of these factors will be taken into account in the model as a fixed effect. Ethics and dissemination: The Patient Protection Committee North-West II approved this study on 4 February 2021 (IRB 2020-A02247-32). The results will be the subject of scientific communications and publications. Trial registration number: NCT04823104.
MeSH term(s)	Pregnancy ; Female ; Humans ; Prenatal Care/methods ; Follow-Up Studies ; Parturition ; Pregnant Women ; Research Design ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-02-16
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-060337
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Article ; Online: Évolution du Shock Index obstétrical lors d’une hémorragie du post-partum selon le recours à la sulprostone.

Cahierc, Romain / Debost-Legrand, Anne / Lane, Sophie / Rouzaire, Marion / Bonnin, Martine / Delabaere, Amélie / Gallot, Denis

Gynecologie, obstetrique, fertilite & senologie

2023 Volume 51, Issue 10, Page(s) 448–454

Abstract: Objectives: The Shock Index (SI) is used in emergency medicine to assess the severity of active bleeding and in the postpartum context for postpartum haemorrhage (PPH). We investigated the diagnostic value of haemodynamic parameters (SI, heart rate (HR), ...

Title translation	Evolution of the obstetrical Shock Index in postpartum haemorrhage according to the use of sulprostone.
Abstract	Objectives: The Shock Index (SI) is used in emergency medicine to assess the severity of active bleeding and in the postpartum context for postpartum haemorrhage (PPH). We investigated the diagnostic value of haemodynamic parameters (SI, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP)) in predicting subsequent use of uterotonic sulprostone treatment. Methods: This was a retrospective study including parturients with PPH ≥ 500mL between January 2017 and December 2018. Hemodynamic parameters at the diagnosis of PPH were compared according to whether the patient required subsequent sulprostone treatment (sulprostone(+) group) or not (sulprostone(-) group). Results: We included in the analysis 147 patients. The SI was significantly higher in the sulprostone(+) group (0.92±0.28 vs. 0.83±0.22; p=0.04). The SBP (107.2±17.5 vs. 113.8±17.7mmHg; p=0.03), DBP (56.8±12,2 vs. 61.5±13,2mmHg; p=0.04), MAP (73.6±12.6 vs. 78.5±13.4mmHg; p=0.03) were significantly lower in the same group. No difference between AUC of these parameters to predict the use of sulprostone was found (AUC between 0.59 and 0.61). No significant difference was found for the HR between the two groups. Conclusion: The diagnostic value of SI appeared to be low and similar to other haemodynamic parameters in predicting the use of sulprostone.
MeSH term(s)	Female ; Humans ; Postpartum Hemorrhage/diagnosis ; Postpartum Hemorrhage/therapy ; Retrospective Studies ; Dinoprostone ; Shock/diagnosis ; Shock/drug therapy
Chemical Substances	sulprostone (501Q5EQ1GM) ; Dinoprostone (K7Q1JQR04M)
Language	French
Publishing date	2023-08-25
Publishing country	France
Document type	English Abstract ; Journal Article
ZDB-ID	2887456-0
ISSN	2468-7189
ISSN (online)	2468-7189
DOI	10.1016/j.gofs.2023.08.001
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Article ; Online: Measuring the readiness to screen and manage intimate partner violence: Cross-cultural adaptation and psychometric evaluation of the PREMIS tool for perinatal care providers.

Guiguet-Auclair, Candy / Debost-Legrand, Anne / Lémery, Didier / Barasinski, Chloé / Mulin, Blandine / Vendittelli, Françoise

PloS one

2021 Volume 16, Issue 11, Page(s) e0258943

Abstract: Introduction: Pregnancy and perinatal periods are significant risk factors of intimate partner violence (IPV), a major public health problem that could begin or intensify during these periods. Perinatal care providers have a major role in the ... ...

Abstract	Introduction: Pregnancy and perinatal periods are significant risk factors of intimate partner violence (IPV), a major public health problem that could begin or intensify during these periods. Perinatal care providers have a major role in the identification and the management of IPV. This study aimed to cross-culturally adapt into French the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a reliable instrument to assess the knowledge, attitudes and preparedness to address IPV, and to evaluate its psychometric properties. Methods: The PREMIS was cross-culturally adapted by conducting forward and backward translations, following international guidelines. An online cross-sectional study was conducted to assess the psychometric properties of the PREMIS-French in perinatal care providers: data completeness, factor analysis, score distribution, floor and ceiling effects, internal consistency, item-total correlations, inter-subscale correlations and test-retest reliability. Results: The PREMIS was successfully translated and cross-culturally adapted to the context of metropolitan France. The results obtained from 360 perinatal care providers showed good acceptability. Exploratory factor analysis of the "Opinions" items resulted in a six-factor solution with six of the eight subscales of the original structure identified. Good internal consistency (Cronbach's alpha ranging from 0.54 to 0.97) and good test-retest reliability (intraclass correlation coefficients ranging from 0.46 to 0.92) for the "Background" and "Opinions" subscales were found. Discussion: This study provides evidence of the good psychometric properties of the PREMIS-French. This valid instrument will help to understand perinatal care providers' barriers to IPV screening and management and will help to focus on specific lacks of knowledge for developing IPV education programs.
MeSH term(s)	Adult ; Aged ; Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; France/epidemiology ; Humans ; Intimate Partner Violence/prevention & control ; Intimate Partner Violence/psychology ; Male ; Middle Aged ; Perinatal Care ; Physicians/psychology ; Pregnancy ; Psychometrics ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-11-04
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0258943
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Article ; Online: Prediction of Iron Deficiency Anemia in Third Trimester of Pregnancy Based on Data in the First Trimester: A Prospective Cohort Study in a High-Income Country.

Resseguier, Anne-Sophie / Guiguet-Auclair, Candy / Debost-Legrand, Anne / Serre-Sapin, Anne-Françoise / Gerbaud, Laurent / Vendittelli, Françoise / Ruivard, Marc

Nutrients

2022 Volume 14, Issue 19

Abstract: Background: Systematic iron supplementation may be harmful in pregnant women with non-depleted iron. Our objectives were to estimate the prevalence of anemia at the third trimester of pregnancy (T3) and to identify the parameters at the first trimester ( ... ...

Abstract	Background: Systematic iron supplementation may be harmful in pregnant women with non-depleted iron. Our objectives were to estimate the prevalence of anemia at the third trimester of pregnancy (T3) and to identify the parameters at the first trimester (T1), which best predict anemia at T3. Methods: This prospective cohort study in France included pregnant women at T1 without non-iron deficiency anemia. Clinical and social characteristics, health-related quality of life, blood count, and a frozen blood sample were collected at T1 and/or T3. Secondly, a matched nested case−control study was built for women with anemia at T3 but not at T1. Multivariate analyses and ROC curves were used to identify the best predictive parameter(s) of anemia at T3. Results: The prevalence of anemia at T3 in the cohort (629 women) was 21.9% (95% CI 18.7−25.2%). In the matched nested case−control study (256 women), hemoglobin (Hb), serum ferritin (SF) and the SF/soluble transferrin receptor ratio at T1 were predictive of anemia at T3 (p < 0.001); however, clinical and social characteristics, as serum hepcidin were not. In multivariate analyses, Hb at T1 was the best predictive biomarker of anemia at T3 with a cut-off value of 120 g/L (specificity 87.5%). Conclusions: The prevalence of anemia at the end of pregnancy remained high in a High-Income Country. Clinical, social, and biochemical parameters did not seem useful to predict anemia at T3 and could not guide iron supplementation. We suggest systematically performing a simple blood count in the first trimester of pregnancy and offering oral iron supplementation for women with Hb < 120 g/L.
MeSH term(s)	Anemia ; Anemia, Iron-Deficiency/diagnosis ; Anemia, Iron-Deficiency/epidemiology ; Biomarkers ; Case-Control Studies ; Cohort Studies ; Female ; Ferritins ; Hemoglobins/metabolism ; Hepcidins ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Prospective Studies ; Quality of Life ; Receptors, Transferrin
Chemical Substances	Biomarkers ; Hemoglobins ; Hepcidins ; Receptors, Transferrin ; Ferritins (9007-73-2)
Language	English
Publishing date	2022-10-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14194091
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Article: Cross-Cultural Adaptation and Psychometric Properties of the French Version of the EXIT to Measure Women's Experiences of Induction of Labor.

Guiguet-Auclair, Candy / Rouzaire, Marion / Debost-Legrand, Anne / Dissard, Sigrid / Rouille, Manon / Delabaere, Amélie / Gallot, Denis

Journal of clinical medicine

2022 Volume 11, Issue 14

Abstract: Background: In France, more than 20% of women require induction of labor (IOL), which can be psychologically and emotionally challenging for patients. It is important to assess how they feel about their IOL experiences. Our aim was to cross-culturally ... ...

Abstract	Background: In France, more than 20% of women require induction of labor (IOL), which can be psychologically and emotionally challenging for patients. It is important to assess how they feel about their IOL experiences. Our aim was to cross-culturally adapt and evaluate the psychometric properties of a French version of the EXIT to assess women's experiences of IOL. Methods: The EXIT was cross-culturally adapted by conducting forward and backward translations following international guidelines. A cross-sectional study was conducted to assess the psychometric properties of the ten French EXIT items: data completeness, factor analysis, internal consistency, score distribution, floor and ceiling effects, inter-subscale correlations, convergent validity, and test-retest reliability. Results: The EXIT was successfully cross-culturally adapted to the French context and any IOL method. The results obtained from 163 patients requiring IOL showed good acceptability. Exploratory factor analysis resulted in a three-factor solution with subscales reflecting the experiential aspects of time taken to give birth, discomfort with IOL, and subsequent contractions. Good internal consistency (Cronbach's alpha or Spearman correlation coefficients ranging from 0.55 to 0.84) and good test-retest reliability (intraclass correlation coefficients ranging from 0.66 to 0.85) for the three identified subscales were found. Conclusions: The ten-item French EXIT is a valid and reliable instrument for the self-assessment of women's experiences of IOL in the three weeks following delivery for any method of IOL used. As a patient-reported outcome measure, it would allow the comparison of experiential outcomes across IOL studies in order to include women's preferences in decisions regarding their care.
Language	English
Publishing date	2022-07-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11144217
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