[Who delivers where? Who is born where? Analysis of the 1997-1998 AUDIPOG Sentinel Network].
OBJECTIVE
The purpose of this study was to describe the care level, legal status and size of the maternity units where deliveries take place in France according to risk level for mother and infant. We analyzed the 1997-1998 data to better implement the network's perinatal policy.


METHODS
and methods. Our standardized sample included 4200 single births in 1997 and 3650 in 1998 collected by the French Sentinel Network after applying a sample rectification technique to offset the methodological problems created by the volunteer nature of the sample population. Distribution of care level, legal status and size of the maternity unit where deliveries took place were recorded according to the risk level of the patients.


RESULTS
In 1997-1998, 22% of pregnant women delivered in level III maternity units and 33% in level II units. Twenty percent of the deliveries took place in level II maternity units with less than 1500 deliveries per year. During this period, women with diabetes or hypertension delivered more often in level III units (31% and 27% respectively) than women in the general population. This was not true for women with a previous perinatal death (23%). Inversely, births of infants before 33 weeks gestation or weighing less than 1500 g occurred more often in level III maternity units (55% and 59% respectively) than in the general population. Twenty-seven percent of the infants requiring neonatal transportation were born in level I maternity units. For 'low risk' mothers, delivery occurred more often in level I maternity units (more than 50%) or in small maternity units with less than 1000 deliveries per year (45%) than for the general population (45% and 36% respectively).


CONCLUSIONS
These data obtained from the Sentinel Network provide precise information on where deliveries occur in France. These data will be useful for implementing the network's perinatal policy. They will also provide a means of following referral practices in the future.
David
S
S
INSERM U369, Centre de recherche de l'INSERM, 151, cours Albert-Thomas, 69424 Lyon Cedex 03.
Mamelle
N
N
Rivière
O
O
D001723:Birth Rate; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D005602:France; D005865:Gestational Age; D006276:Health Facility Size; D006801:Humans; D007231:Infant, Newborn; D009775:Obstetrics and Gynecology Department, Hospital / Q000331:legislation & jurisprudence; D011247:Pregnancy; D011248:Pregnancy Complications; D011787:Quality of Health Care; D012307:Risk Factors