[Maternal mortality and severe morbidity in 3 French regions: results of MOMS, a European multicenter investigation].
Maternal mortality rates vary between different European countries. One hypothesis put forward to explain such differences is the potential discrepancy in the incidence of the main obstetrical complications. A European concerted action designed to estimate the incidence of severe post partum hemorrhage (> 1.5 l), PET, and sepsis was carried out in 1995-96 (MOMS-B survey) using standardized definitions and the same questionnaire in all regions. In the 13 regions in Europe involved in the study, including Champagne-Ardenne, Center and Lorraine in France, 1843 cases of obstetrical complication were identified among 182,589 births. The overall mean rate of severe maternal morbidity was 10.1 for 1000 births. This rate was 8.0 for Lorraine, 6.7 for Champagne-Ardenne and 5.5 for Center. The rates of hemorrhage and PET in the United Kingdom, Belgium and Finland were twice the rates in France and Norway. The inverse was observed for sepsis. Such discrepancies between countries, despite the use of standardized definitions, raises several questions. Was the methodology correctly applied? Were threatening situations correctly assessed in France? Was disease severity assessed in the same way in all countries? Further studies would be required to answer these questions.
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Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 149, Recherches Epidémiologiques en santé périnatale et santé maternelle, 123, bd Port-Royal, 75014 Paris. bouvier@cochin.inserm.fr
Varnoux
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D005060:Europe; D005260:Female; D005602:France / Q000453:epidemiology; D017359:HELLP Syndrome / Q000453:epidemiology; D006801:Humans; D007239:Infections / Q000453:epidemiology; D008428:Maternal Mortality; D009017:Morbidity; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011644:Puerperal Disorders / Q000453:epidemiology