[Audipog perinatal network 2004-2005. Part 2: assessment of medical practices].
OBJECTIVE
To describe specific clinical practices in France in 2004-2005 based on data from the Audipog sentinel network.


METHODS
The database for 2004 and 2005 covers 71406 pregnancies from 86 maternity units throughout the year. We constructed a random subsample each year by including only the births occurring during a single month for each maternity ward. Our study therefore analyzes 6987 pregnancies in 2004 and 7648 pregnancies in 2005.


RESULTS
Among the very preterm (<33 weeks of gestation) infants from multiple pregnancies, 77.4% were born in level 3 hospitals in 2000-2001, and only 44.9% in 2004-2005 (p<0.0001). Among the very preterm infants from singleton pregnancies, the percentage born in level 3 maternity hospitals rose between 1996-1997 and 2004-2005 (55% versus 73%; p=0.001). The rate of corticosteroid therapy before delivery among very preterm infants did not change significantly between 2000 and 2005 (p=0.58). The cesarean rate rose from 14% in 1994 to 20.0% in 2005. The percentage of actively managed third stages of labor increased from 1994-1995 to 2005 (6.2% versus 31.3%). Fewer episiotomies were performed: 56% in 1994-1995 and 41.3% in 2005. Exclusive breast-feeding rose from 51.2% in 2000-2001 to 58.5% in 2005 (p<0.0001). Early discharge increased between 1994-1995 and 2005 (p<0.0001).


CONCLUSIONS
Indicators monitoring implementation of some of the national clinical practice guidelines have improved slightly over time, although most often before the publication of these guidelines.
Vendittelli
F
F
Association des utilisateurs de dossiers informatisés en pédiatrie, obstétrique et gynécologie, faculté de médecine RTH Laennec, 7, rue Guillaume-Paradin, 69372 Lyon cedex 8, France. fvendittelli@chu-clermontferrand.fr
Rivière
O
O
Crenn-Hébert
C
C
Claris
O
O
Tessier
V
V
Pinquier
D
D
Teurnier
F
F
Lansac
J
J
Maria
B
B
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D018743:Perinatal Care / Q000379:methods / Q000592:standards* / Q000639:trends*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011787:Quality of Health Care; D055815:Young Adult