[Regionalization of perinatal care helps to reduce neonatal mortality and morbidity in very preterm infants and requires updated information for caregivers].
In 1997 a large French epidemiological study (Epipage) showed increased mortality and morbidity in Languedoc Roussillon when compared to other regions of France. In order to update information, we set up a regional database about very preterm infants born in Languedoc-Roussillon since 2003. Our objective was to analyze the evolution of mortality and of the morbidity in very preterm infants between 1997 and 2003-2005.


METHODS
We analyzed mortality and the morbidity (respiratory, neurological, digestive) of the very preterm infants born alive between 22 and 32 weeks amenorrhea and admitted alive in neonatology included in Epipage study in 1997 and of those included in the regional database in 2003-2005. Between these 2 periods, professional practices were significantly improved as the perinatal network was set up and perinatal care was regionalized.


RESULTS
We analyzed the data collected in 3121 subjects of Epipage study and 1111 subjects of the regional database. We observed a significant reduction (P<0.05) of neonatal mortality (8% versus 23%), rate of bronchopulmonary dysplasia (9% versus 19%) and of periventricular leukomalacia (9% versus 18%). During this period, there were significant increases (P<0.05) in the rates of antenatal corticotherapy (87% versus 61%) and caesarean section (72% versus 38%).


CONCLUSIONS
We observed a significant improvement of morbidity of very preterm infants and a decreased mortality for the youngest subjects which was concomitant of an improvement of the professional's practices. It is necessary to take into account these results to propose relevant informations to the professionals with and thus indirectly to the parents.
Veit-Sauca
B
B
Service de néonatologie et réanimation néonatale, pédiatrie 2, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34000 Montpellier, France.
Boulahtouf
H
H
Mariette
J-B
JB
Thevenot
P
P
Gremy
M
M
Ledésert
B
B
Boulot
P
P
Picaud
J-C
JC
D005602:France; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000628:therapy*; D018743:Perinatal Care / Q000458:organization & administration*; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000458:organization & administration*