[Preterm births circumstances in babies born before 35 weeks in French Alpes: PREMALP study].
OBJECTIVE
In a regional study of preterm infants born before 35weeks of gestation, the aim was to propose a new classification of preterm births into three groups, and to describe the pregnancy complications and fetal disorders in each group.


METHODS
In two areas covered by a perinatal network, all preterm births, live births and stillbirths, which occurred between 22 and 34 completed weeks were recorded over a 21-month period. Each case was classified either in the medically-indicated preterm birth (I) group, or in the accepted spontaneous preterm birth (ASp) group or in the non-accepted spontaneous preterm birth (NASp) group.


RESULTS
One thousand and sixty cases of preterm births were included; among them, 981 were live births or ended with per partum infant death. Forty-nine percent of these births were medically indicated, 32 % were ASp and 19 % were NASp. The distribution of pregnancy complications and fetal disorders differed between preterm birth groups: ischemic placental diseases were present in 38,2 % of medically-indicated births; preterm premature rupture of membranes occurred twice more often in I and ASp preterm births than in NASp preterm births.


CONCLUSIONS
This classification is based on the medical decision; it allows to compare medical practices in given obstetrical situations. It appears to be reproducible and easy to use.
Delorme
V
V
Département de gynécologie-obstétrique, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. vdelorme@chu-grenoble.fr
Bal
G
G
Equy
V
V
David-Tchouda
S
S
Arnould
P
P
Abraham
L
L
Cans
C
C
Debillon
T
T
D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007511:Ischemia; D010920:Placenta / Q000098:blood supply; D010922:Placenta Diseases / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D047928:Premature Birth / Q000145:classification* / Q000453:epidemiology; D015203:Reproducibility of Results