OBJECTIVE: To identify the main prenatal risk factors for cerebral palsy in ve ry preterm singletons and twins. METHODS: The data were from the Epipage study, which included all very preterm children (< 33 weeks) b...OBJECTIVE: To identify the main prenatal risk factors for cerebral palsy in ve ry preterm singletons and twins. METHODS: The data were from the Epipage study, which included all very preterm children (< 33 weeks) born in 1997 in 9 regions of France. The analysis included 1,954 children for whom a medical questionnaire was completed at the age of 2 years (83%of the surviving children). The risk f actors studied were pregnancy complications and specific factors in twins (type of placenta and death of cotwin). Logistic regression analysis was carried out f or singletons and generalized estimating equation models used for twins. RESULTS : The proportion of cerebral palsy was 8%in singletons and 9%in twins. For sin gletons, spontaneous preterm labor (adjusted odds ratio [OR] 3.4, 95%confidence interval [CI] 1.7-6.7), preterm premature rupture of membranes (PPROM) with sh ort latency (adjusted OR 4.9, 95%CI 2.0-11.8), and prolonged PPROM (adjusted OR 2.7, 95%CI 1.4-5.3) were associated with a higher risk of cerebral palsy than was hypertension. No such link was found between these preg nancy complications and cerebral palsy in twins. For twins, a monochorionic plac enta (OR 1.9, 95%CI 1.0-3.6) increased the risk of cerebral palsy, but the OR became nonsignificant after adjustment (OR 1.7, 95%CI 0.8-3.4). CONCLUSION: In very preterm singletons, spontaneous preterm labor and PPROM increased the risk of cerebral palsy compared with hypertension.展开更多
Objective. The aim of this article is to describe conditions of abortions practices in France. Materials and methods. The study was based on the COCON survey. This survey was carried out among a representative sample ...Objective. The aim of this article is to describe conditions of abortions practices in France. Materials and methods. The study was based on the COCON survey. This survey was carried out among a representative sample of 2863 women aged 18 to 44 living in metropolitan France. Women were interviewed by telephone. The analysis was performed among a sub- sample of 320 women who had had an abortion between 1996 and 2000. Results were compared with those of the national notification of induced abortions. Results. Altogether, the way in which abortions were carried out was appropriate, but differences were observed according to the type of hospital: access to care was easier in the private sector; however a pre- abortion interview was less often carried out and a post- abortion interview less often proposed in the private sector. Besides, in both sectors, women were rarely allowed to choose the abortion technique, or the type of anesthesia in the case of a surgical abortion. Conclusion. The COCON study is the first population based survey describing the characteristics of care regarding voluntary abortion. It shows the persistence of differences in practices between the public and the private sectors.展开更多
文摘OBJECTIVE: To identify the main prenatal risk factors for cerebral palsy in ve ry preterm singletons and twins. METHODS: The data were from the Epipage study, which included all very preterm children (< 33 weeks) born in 1997 in 9 regions of France. The analysis included 1,954 children for whom a medical questionnaire was completed at the age of 2 years (83%of the surviving children). The risk f actors studied were pregnancy complications and specific factors in twins (type of placenta and death of cotwin). Logistic regression analysis was carried out f or singletons and generalized estimating equation models used for twins. RESULTS : The proportion of cerebral palsy was 8%in singletons and 9%in twins. For sin gletons, spontaneous preterm labor (adjusted odds ratio [OR] 3.4, 95%confidence interval [CI] 1.7-6.7), preterm premature rupture of membranes (PPROM) with sh ort latency (adjusted OR 4.9, 95%CI 2.0-11.8), and prolonged PPROM (adjusted OR 2.7, 95%CI 1.4-5.3) were associated with a higher risk of cerebral palsy than was hypertension. No such link was found between these preg nancy complications and cerebral palsy in twins. For twins, a monochorionic plac enta (OR 1.9, 95%CI 1.0-3.6) increased the risk of cerebral palsy, but the OR became nonsignificant after adjustment (OR 1.7, 95%CI 0.8-3.4). CONCLUSION: In very preterm singletons, spontaneous preterm labor and PPROM increased the risk of cerebral palsy compared with hypertension.
文摘Objective. The aim of this article is to describe conditions of abortions practices in France. Materials and methods. The study was based on the COCON survey. This survey was carried out among a representative sample of 2863 women aged 18 to 44 living in metropolitan France. Women were interviewed by telephone. The analysis was performed among a sub- sample of 320 women who had had an abortion between 1996 and 2000. Results were compared with those of the national notification of induced abortions. Results. Altogether, the way in which abortions were carried out was appropriate, but differences were observed according to the type of hospital: access to care was easier in the private sector; however a pre- abortion interview was less often carried out and a post- abortion interview less often proposed in the private sector. Besides, in both sectors, women were rarely allowed to choose the abortion technique, or the type of anesthesia in the case of a surgical abortion. Conclusion. The COCON study is the first population based survey describing the characteristics of care regarding voluntary abortion. It shows the persistence of differences in practices between the public and the private sectors.