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M H Bouvier-Colle

Publications and source records attributed to M H Bouvier-Colle.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Resp-informations].

Explore the source record for details and available documents.

Adrenergic beta-Antagonists↗
PubMed2000

Severe maternal morbidity from direct obstetric causes in West Africa: incidence and case fatality rates.

Data on maternal morbidity make it possible to assess how many women are likely to need essential obstetric care, and permit the organization, monitoring and evaluation of safe motherhood programmes. In the present paper we propose operational definitions of severe maternal morbidity and report the frequency of such morbidity as revealed in a population-based survey of a cohort of 20,326 pregnant women in six West African countries. The methodology and questionnaires were the same in all areas. Each pregnant woman had four contacts with the obstetric survey team: at inclusion, between 32 and 36 weeks of amenorrhoea, during delivery and 60 days postpartum. Direct obstetric causes of severe morbidity were observed in 1215 women (6.17 cases per 100 live births). This ratio varied significantly between areas, from 3.01% in Bamako to 9.05% in Saint-Louis. The main direct causes of severe maternal morbidity were: haemorrhage (3.05 per 100 live births); obstructed labour (2.05 per 100), 23 cases of which involved uterine rupture (0.12 per 100); hypertensive disorders of pregnancy (0.64 per 100), 38 cases of which involved eclampsia (0.19 per 100); and sepsis (0.09 per 100). Other direct obstetric causes accounted for 12.2% of cases. Case fatality rates were very high for sepsis (33.3%), uterine rupture (30.4%) and eclampsia (18.4%); those for haemorrhage varied from 1.9% for antepartum or peripartum haemorrhage to 3.7% for abruptio placentae. Thus at least 3-9% of pregnant women required essential obstetric care. The high case fatality rates of several complications reflected a poor quality of obstetric care.

Adult↗
PubMed1999

Participation in a mail survey: role of repeated mailings and characteristics of nonrespondents among recent mothers.

This study analysed the characteristics of respondent and nonrespondent mothers at each stage of a survey procedure, from a initial questionnaire to a reminder letter and two repeated mailings. Of 938 mothers of liveborn children who, while maternity inpatients, received a questionnaire and information about a mail survey to follow 2 months later, 828 completed and returned the initial questionnaire, 708 agreed to participate in the mail survey and were sent the mail questionnaire, and 612 finally completed and returned the questionnaire at 2 months. There were differences between respondents and non-respondents for socio-demographic factors at each stage of the process. The final response rate to the mail questionnaire was higher among mothers who were younger, were breast feeding, and had more education, an occupation and fewer children. The characteristics of late respondents were intermediate between those of early to middle respondents and nonrespondents for age, educational level, breast feeding and occupation. Maternal and infant health varied only slightly according to response status. Repeated mailings increased response and diminished selection. A mail questionnaire after contact in a maternity ward is a cost-effective means of gathering data about a large sample of recent mothers and their children.

Adult↗
PubMed1999

Classification differences and maternal mortality: a European study. MOMS Group. MOthers' Mortality and Severe morbidity.

OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected. RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001). CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

Cause of Death↗
PubMed1999

[Do obstetric causes of death explain the differences in maternal mortality between France and Europe?].

In view of understanding why the level of maternal mortality is higher in France than in other European countries, a specific study of frequency and causes has been carried out in these 13 countries. Two different sources of data were used: the annual civil death data from national offices which are published by the WHO, and the MOMS data. It was hypothesized that the pattern of causes plays a role in the level of maternal mortality. This hypothesis was checked with results issuing from a European concerted action where deaths were classified by a European group of medical experts using identical criteria. There were apparently more cases of hemorrhage, direct obstetric causes, and indirect obstetric causes in France than in the other European countries. The higher level of indirect obstetric causes may be explained by stronger registration regulations for maternal deaths recently implemented in France. Due to the higher level of hemorrhage as cause of maternal death in France, we suggest in-depth research is needed in the near future to study prevalence and management of obstetrical hemorrhage in France.

Cause of Death↗
PubMed1999

[Infant temperament at 6-9 months old: validation of the French version of the Infant Characteristics Questionnaire and factors associated with measurement].

BACKGROUND: The aim of the study was to assess the validity of the French version of the Infant Characteristics Questionnaire (ICQ), which was developed by Bates in 1979 to investigate the parental perceptions of infant temperament at 6 months of age. METHODS: The French version was established after translation/back-translation, and tested on a sample of 794 mothers, who gave birth in 1995 in four French Departments and who returned the questionnaire which was mailed 6 months after the birth. RESULTS: The non-response rate of each item was very low (< 2%). Factor analysis resulted in the same four factors as in the American data: fussy/difficult, unadaptable, unpredictable, dull. However, some of the items did not have similar factor loadings. Thus new factor scores were defined for the French version of the ICQ. Internal consistency, as measured by the Cronbach coefficient, was satisfactory (> 0.7) for the factors fussy/difficult and unadaptable. It was lower, but acceptable (> 0.6) for the two other factors. The infant's temperament was not related to birth parameters. In contrast, some factor scores were significantly associated with parity, mother's education, as well as her health and the infant's health after leaving the maternity ward. CONCLUSIONS: The French version of the ICQ is well accepted and has a good validity. This scale provides a useful instrument for research, especially for epidemiological studies on infant health and development, as well as their determinants.

Adult↗
PubMed1998

Risk factors for maternal condition at admission to an intensive care unit: does health care organisation play a role? Study Group of the Maternal Morbidity.

The objective of this study was to analyse the relation between severity of maternal condition at the time of intensive care unit (ICU) admission and various individual and institutional factors. This study analysed data from a retrospective population-based study in three French regions during 1991. The population study included 355 patients who were admitted to an ICU during pregnancy, delivery or within 42 days after delivery, for an obstetrical cause. The main outcome measure was the severity of maternal condition at ICU admission estimated from the level of consciousness and from the Simplified Acute Physiology Score (SAPS). The most severe maternal condition was associated with a change in hospital category (from the initially chosen hospital to the hospital referring for ICU) (OR 3.8, 95% CI 1.5-9.6) and with treatment in a private hospital at ICU referral (OR 3.3, 95% CI 1.3-8.3). Foreign nationality was the only individual factor related to very severe maternal condition. These results suggest that health care organisation during pregnancy affects the prognosis of severe maternal condition. The factors involved appear to include the management of unpredictable disorders, the conditions of maternal transfers before ICU admission, and antenatal care of foreigners.

Adult↗
PubMed1998

[Information campaign on child care practices: measure of the effects on sleep position and sudden infant death syndrome].

BACKGROUND: To define the prevalence of the child care practices questioned in the sudden infant death syndrome (SIDS), especially the prone sleep position, before and after an information campaign. To evaluate the effects of this action on the postneonatal mortality. METHOD: A population survey was conducted in four French departments among mothers of infants born in March 1994 and March 1995 and aged 5 days and 2.5 months. A specific information campaign was conducted among health personnel in October 1994. RESULTS: After the information campaign, the prevalence of prone sleeping dramatically decreased at both ages studied: from 6.8% to 1.1% at 5 days and from 24.5% to 7.2% at 2.5 months. Duvets were used less whereas the other practices (bed sharing, using pillow, breastfeeding, maternal smoking) did not change. The postneonatal SIDS rate significantly decreased, from 1.1 p. 1000 live births in 1994 to 0.7 in 1995, the mortality from others causes also declined; the overall postneonatal mortality was 2.7 p. 1000 before the action and 2.1 p. 1000 after. CONCLUSION: The sleeping position which is the main factor questioned in SIDS was modified, and the postneonatal mortality decreased. The specific action conducted for the present epidemiological research is probably not the only contributor in these positive results.

Adult↗
PubMed1997

Case-control study of risk factors for obstetric patients' admission to intensive care units.

OBJECTIVE: To identify risk factors among pregnant and newly delivered women to be treated in intensive care unit (ICU). STUDY DESIGN: A case-control survey of pregnant women or delivered within the past 42 days admitted to ICU was performed in three regions of France. Two controls by subject were matched for hospital and outcome (vaginal delivery, caesarean section, abortion or ectopic pregnancy). Bivariate and multivariate analyses, using different models were done. The conference intervals (CI) are 95% intervals. The odds ratio (OR) were adjusted on matching factors in univariate analysis, and adjusted on all factors included in the multivariate analysis. RESULTS: 375 subjects treated in ICU and 750 controls were included in the study. These women did not differ in age, marital status or social class, but the cases were more often of non-European nationality. They had more often medical antecedents which were also more serious. The subjects consulted at the maternity facility less frequently than did controls. The following variables increased the risk of ICU admission: no maternal consultation at the maternity ward (OR 2.8, CI 1.5-5.1) serious past medical history (OR 2.7, CI 2.0-3.6), non-European ascertained before the condition of the patient worsens it is argued that more attention could be paid to them. Regarding the risk associated to multiple pregnancy, further efforts to prevent them ought to be considered.

Adult↗
PubMed1997

[Intensive care of pregnant and puerperal women. Characteristics of patients and health management structures].

INTRODUCTION: In order to understand why maternal mortality is higher in France than in other comparable countries, an epidemiological survey was carried out concerning critical illness during pregnancy, delivery and post partum, to ascertain the frequency of critical illnesses, and describe the characteristics of the patients as well as of the obstetrical services caring for them. MATERIAL AND METHOD: The survey was carried out on all obstetric patients treated in intensive care units (ICU), in three French regions for one year. A detailed questionnaire was retrospectively filled out by a specialized investigator, according to the patient's medical file. RESULTS: The frequency of critical illness was estimated at 310 SD 36 per 100,000 live births. Hypertensive diseases (26%) are the most frequent diagnosis that motivated admission to ICU, followed by the hemorrhages (20%), and then the indirect obstetric causes (17%). A large part of these patients was affected by seriously poor conditions before the present pregnancy. Public hospitals were most often implicated in the care of these patients since the beginning of the pregnancy and still more at the moment of the delivery. There was no difference in prenatal care from one type of hospital to another. On the contrary, pathologies and hospitalisation during pregnancy then the causes and the time of admission to ICU as well as the seriousness of maternal conditions were statistically different from one type of hospital to much more frequently in such pregnancies. Letality did not differ according to the various classes of maternity ward but did differ according to the pathologies leading to the treatment in ICU. CONCLUSION: A large proportion of pregnant women experience seriously critical illness; the relationship between critical illness and maternal mortality according to health care must be studied in depth.

Critical Care↗
PubMed1996

Obstetric patients treated in intensive care units and maternal mortality. Regional Teams for the Survey.

OBJECTIVE: To ascertain the frequency of serious diseases in pregnant women. STUDY DESIGN: A population based survey was performed in France. The cases were all the women admitted for treatment in intensive care unit (ICU). The severity of the cases was measured with the simplified acute physiology score (SAPS) the lethality and the rate of still birth. RESULTS: 435 obstetric patients were included. The estimated frequency of severe diseases was 310 S.D.36 per 100,000 live births. The most frequent diagnose that motived admission in ICU was hypertensive diseases. The lethality rates differed greatly between specific disorders. The lethality rate was lower when scheduled maternity was located in a teaching hospital. CONCLUSION: Regarding these results it appears that the majority of obstetric patients with severe diseases are referred to suitable care, but a small proportion of women who had to change their type of care registered a significant higher lethality.

Female↗
PubMed1996

The likely increase in maternal mortality rates in the United Kingdom and in France until 2005.

In the UK, the decline in maternal mortality rates has stopped. In France, where they are higher than in most European countries, maternal mortality rates have been increasing since 1990. Based on the population projections published by Eurostat, maternal mortality predictions have been made for 1995, 2000, 2005 and 2010. A rise in the level of maternal mortality rates of more than 0.5 per 100000 livebirths is expected between now and 2005, in both countries. In the present context of near stability, this rise could be viewed as an important increase. Maternal mortality rises with maternal age and the proportion of births to women over thirty is growing and will continue to rise until 2000-2005. This structural and demographic evolution explains the expected rise of maternal mortality rates and shows how the change in the maternal age distribution of births will affect these rates.

Adolescent↗