[What are the neonatal risks in low-risk pregnancies: implications for the organization of birth centers].
OBJECTIVE
This study was designed to identify pregnant women at low risk for severe neonatal morbidity. This population should apply for delivery in birth centers.


METHODS
This study was retrospective and included all livebirths in Burgundy over a 4-year period. Fifteen obstetric criteria recorded in the regional perinatal database were used to select pregnant women at low risk for severe neonatal morbidity. Incidence of severe neonatal morbidity in the low and high risk groups was assessed from the following markers: postnatal death; severe neurological conditions (ischemic encephalopathy, seizures, meningitis, intraventricular hemorrhage stage 3-4 and cystic periventricular leukomalacia in preterm infants); tracheal intubation; hospitalization in neonatal intensive care unit.


RESULTS
The incidence of severe neonatal morbidity was significantly different (P<0.0001) in the low risk group (0.34% [IC 95%: 0.29-0.40]; N=46345) as compared with the high risk group (5.6% [IC 95%: 5.3-5.9]; N=24961). The main neonatal diseases in the low risk group were: respiratory diseases (29.8%); congenital heart diseases (17.9%) and perinatal asphyxia (15.3%).


CONCLUSIONS
Even though the low risk criteria were associated with a low incidence of severe neonatal morbidity, residual morbidity should be considered in organization of birth centers in France.
Gay
S
S
Service de pédiatrie et néonatologie, centre hospitalier de Chalon-sur-Saône, 7, quai de l'Hôpital, 71100 Chalon-sur-Saône, France. sebastien.gay@ch-chalon71.fr
Ferdinus
C
C
Sagot
P
P
Gouyon
J-B
JB
D016550:Birthing Centers / Q000458:organization & administration; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies