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Accouchements inopinés à domicile ou « en route » dans le Sud de l’île de La Réunion : 656 naissances en 15 ans

Abstract : Aims: To analyse the risk factors associated with home births and “en-route” deliveries that occurred in the south of Reunion Island. Patients and methods: Since 2001, all births have been recorded in an epidemiological database from 22 weeks’ gestation, including maternal and neonatal information. This study is based on a 15-year period (1/01/2001–31/12/2015). Results: Over this period, there were 656 cases of home births recorded across a total of 81,511 of all births in South Reunion (0.8%). Compared with births in maternity units, these deliveries occurred on the whole at night (67% vs. 54%, OR: 1.74 [1.4–2.1]), by multiparous women (OR: 5 [3.7–6.2]) and and highly multiparous women (5 or more children, OR: 4.1 [3.5–4.9]), women aged over 35 years (OR: 1.4 [1.2–1.7]), in single-parent families (women who live alone, OR: 1.47 [1.3–1.7]), households from a lower socioeconomic (without work OR: 1.24 [1.2–1.3]) and educational (primary or secondary school, OR: 2.4 [2.0–2.9]) background, and who had received fewer prenatal checkups (number of visits 6.4 vs. 9.0). From a neonatal point of view, prematurity was more common (17 vs. 9.9%, OR: 1.9 [1.6–2.4]), as was severe prematurity (< 33 weeks, 5.1 vs. 2.2%, OR: 2.38 [1.7–3.4]) and transfers to a neonatal unit (12.7 vs. 8.0%, OR: 1.67 [1.3–2.1]) were more significant (P< 0.0001). There were 43 perinatal deaths (9.4%, OR: 3.2 [2.3–4.6]) and one maternal death, in a 26-year old highly multiparous woman. Conclusions: In this context, specific monitoring of multiparous women from a low socioeconomic background appears to be a priority.
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Eric Razafimanantsoa, Pierre-Yves Robillard, Cyrille Desveaux, Silvia Iacobelli, Francesco Bonsante, et al.. Accouchements inopinés à domicile ou « en route » dans le Sud de l’île de La Réunion : 656 naissances en 15 ans. Revue de médecine périnatale, Springer Link 2017, ⟨10.1007/s12611-017-0399-7⟩. ⟨hal-01634351⟩

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