[Regionalization of perinatal care in the Seine-Saint-Denis department of France].
OBJECTIVE
To evaluate a policy designed to regionalize perinatal care in the Seine-Saint-Denis department of France.


METHODS
The place of birth of every preterm infant (born before 33 weeks gestation) in 1998-1999 was compared with that for the period of 1989-1992. The 1989-1992 data came from a prenatal mortality study. For the 1998-1999 period, we used data from an area-based birth registry recording an experimental health certificate.


RESULTS
In 1989-1992, 40% of live births before 33 weeks gestation took place in level I maternity units, 37.2% in level II maternity units, and 13.0% in level III maternity units. In 1998-1999, 5.4% took place in level I maternity units, 28.9% in level II maternity units and 65.1% in level III maternity units. The number of postnatal transfers of very preterm infants declined markedly. In 1998-1999, 109 pregnant women were transferred to a level III maternity hospital. This constituted 1.2% of the women who gave birth in Seine-Saint-Denis during this period.


CONCLUSIONS
The policy to regionalize perinatal care and increase maternal transfers was well accepted and successfully implemented. The delivery of very preterm infants in maternity hospitals without neonatal units became a rare event.
Papiernik
E
E
Université René Descartes, Faculté de Cochin-Port-Royal, Paris.
Bucourt
M
M
Zeitlin
J
J
Senanedj
P
P
Topuz
B
B
D005260:Female; D005602:France; D005865:Gestational Age; D006771:Hospitals, Maternity; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D018743:Perinatal Care; D011247:Pregnancy; D012042:Registries; D014187:Transportation of Patients