{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T09:29:08Z","timestamp":1789896548317,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,3,29]],"date-time":"2020-03-29T00:00:00Z","timestamp":1585440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The objective of this study is to investigate factors associated with risks of perinatal death in a disadvantaged, high\u2010migrant French district with mortality rates above the national average.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The study design is a perinatal audit in 2014 in all 11 maternity units in the Seine\u2010Saint\u2010Denis district (25\u00a0037 births). The data come from medical chart abstraction, maternal interviews and peer assessor confidential review of deaths. A representative sample of live births in the same district, from the 2010 French Perinatal Survey, was used for comparisons (n\u00a0=\u00a0429). The main outcome measures were stillbirth and neonatal death (0\u201027\u00a0days) at \u226522\u00a0weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The audit included 218 women and 227 deaths (156 stillbirths, 71 neonatal deaths); 75 women were interviewed. In addition to primiparity and multiple pregnancy, overweight and obesity increased mortality risks (50% of cases, adjusted odds ratios [aOR] 1.7, 95% confidence interval [CI] 1.1\u20102.8, and aOR 1.9 [95% CI 1.1\u20103.2], respectively) as did the presence of preexisting medical\/obstetric conditions (28.6% of cases, aOR 3.2, 95% CI 2.0\u20105.3). Problems accessing or complying with care were noted in 25% of medical records and recounted in 50% of interviews. Assessors identified suboptimal factors in 73.2% of deaths and judged 33.9% to be possibly or probably preventable. Care not adapted to risk factors and poor healthcare coordination were frequent suboptimal factors. Possibly preventable deaths were higher (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.05) for women with gestational diabetes or hypertension (44.6%) than women without (29.0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preventive actions to improve healthcare referral and coordination, especially for overweight and obese women and women with medical and obstetrical risk factors, could reduce perinatal mortality in disadvantaged areas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13838","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T23:55:28Z","timestamp":1583884528000},"page":"1163-1173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Understanding high rates of stillbirth and neonatal death in a disadvantaged, high\u2010migrant district in France: A perinatal audit"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-6655","authenticated-orcid":false,"given":"Priscille","family":"Sauvegrain","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris CRESS (Obstetrical, Perinatal and Pediatric Epidemiology Research Team EPOP\u00e9) INSERM INRA Paris France"},{"name":"Department of Obstetrics and Gynecology Parisian Hospital AP\u2010HP Piti\u00e9\u2010Salp\u00eatri\u00e8re Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Carayol","sequence":"additional","affiliation":[{"name":"Department of Families and Early Childhood Maternal and Child Protection Service, Paris City Hall Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Piedvache","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris CRESS (Obstetrical, Perinatal and Pediatric Epidemiology Research Team EPOP\u00e9) INSERM INRA Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Gu\u00e9ry","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris CRESS (Obstetrical, Perinatal and Pediatric Epidemiology Research Team EPOP\u00e9) INSERM INRA Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Br\u00e9art","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris CRESS (Obstetrical, Perinatal and Pediatric Epidemiology Research Team EPOP\u00e9) INSERM INRA Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Bucourt","sequence":"additional","affiliation":[{"name":"Departmental Maternal and Child Protection Service Seine\u2010Saint\u2010Denis General Council Bobigny France"},{"name":"Anatomical Pathology Department Parisian Hospital AP\u2010HP Jean Verdier Bondy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris CRESS (Obstetrical, Perinatal and Pediatric Epidemiology Research Team EPOP\u00e9) INSERM INRA Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the REMIP Investigator Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0804-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001100"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494808089653"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-11-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3016.2000.00266.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2012.10.012"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.090308"},{"key":"e_1_2_9_9_1","unstructured":"INSEE.Mortalit\u00e9 infantile par d\u00e9partement et r\u00e9gion: S\u00e9ries depuis 1990. 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