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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mercredi 23 janvier 2019
Doi : 10.1016/j.accpm.2018.12.007
Maternal admissions to intensive care units in France: Trends in rates, causes and severity from 2010 to 2014
 

Y. Barry a, , C. Deneux-Tharaux b, M. Saucedo b, V. Goulet c, I. Guseva-Canu a, d, N. Regnault a, 1, A.A. Chantry b, c, 1
a Santé publique France, non-communicable diseases and trauma division, 12, rue du Val d’Osne, 94415 Saint-Maurice cedex, France 
b Inserm U1153, Perinatal and paediatric obstetrical epidemiology research team (EPOPé), Centre for epidemiology and statistics (CRESS), Paris Descartes University, Risks and Pregnancy DHU, Maternité Port-Royal, 53, avenue de l’Observatoire, 75014 Paris, France 
c Midwifery school of Baudelocque, AP–HP, Paris Descartes University, DHU risks and pregnancy, 75006 Paris, France 
d Institute for work and health (IST), University of Lausanne, University of Geneva, Epalinges-Lausanne, Switzerland 

Corresponding author at: 12, rue du Val d’Osne 94415 Saint-Maurice Cedex, France12, rue du Val d’OsneSaint-Maurice Cedex94415France
Abstract
Introduction

Maternal intensive care unit admission is an indicator of severe maternal morbidity. The objective of this study was to estimate rates of maternal intensive care unit admission during or following pregnancy in France, and to describe the characteristics of women concerned, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014.

Methods

Women hospitalised in France in intensive care units during pregnancy or up to 42 days after pregnancy between January 2010 and December 2014 were identified using the national hospital discharge database (PMSI-MCO). Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model.

Results

In total, 16,011 women were admitted to intensive care units, representing an overall incidence of 3.97‰ deliveries. This number decreased significantly by 1.7% on average per year. For women who gave birth (60.5% by C-section), 62.5% of admissions occurred during their hospitalisation for delivery. The SAPS II score, an indicator of severity, significantly increased from 18.4 in 2010 to 21.5 in 2014. Obstetrical haemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. In mainland France, the Ile-de-France (i.e., greater Paris) region had the highest rates of intensive care units admission (5.05‰) while the Pays-de-la-Loire region had the lowest (2.69‰).

Conclusion

The rate of maternal intensive care unit admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. In-depth studies are needed to understand the territorial disparities identified.

The full text of this article is available in PDF format.

Keywords : Obstetric admissions, Intensive care unit, Pregnancy, Hospital discharge database, Prevalence, Trends, Regional disparities


1  Co-last authors.


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