{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:08Z","timestamp":1791331208714,"version":"4.3.1"},"reference-count":41,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2009,4,5]]},"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess evolution in the care and health of very preterm babies between 1998 and 2003 after implementation of a regionalisation policy in France.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Comparison of two population-based cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>The Parisian region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>All live births at 24\u201331 weeks of gestation in 1997 (EPIPAGE study, n=488) and in 2003 (MOSAIC study, n=580).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Implementation of regionalised perinatal networks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>In-hospital mortality and morbidity, including intraventricular haemorrhage (IVH) grade III and IV, cystic periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over this period, babies born in level III units rose from 67% to 77% and use of antenatal corticosteroids, indicated deliveries and surfactant increased. In-hospital mortality and IVH grades III\/IV declined, ORs of 0.66 (95% CI 0.46 to 0.95) and 0.27 (95% CI 0.15 to 0.47), respectively, while PVL and BPD stayed constant. The rate of very preterm babies discharged alive per 1000 total births increased by 18%, but declined for babies with severe brain lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The authors found improvements in mortality and morbidity for very preterm babies and changes in their care over a 6-year period following reinforcement of regionalisation policies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/adc.2008.156745","type":"journal-article","created":{"date-parts":[[2009,4,24]],"date-time":"2009-04-24T20:24:07Z","timestamp":1240604647000},"page":"F188-F193","source":"Crossref","is-referenced-by-count":50,"title":["Changes in care and outcome of very preterm babies in the Parisian region between 1998 and 2003"],"prefix":"10.1136","volume":"95","author":[{"given":"Jennifer","family":"Zeitlin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Yves","family":"Ancel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Delmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Br\u00e9art","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Papiernik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EPIPAGE and the MOSAIC Ile-de-France Groups","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,4,23]]},"reference":[{"key":"2025090511173616000_95.3.F188.1","doi-asserted-by":"crossref","first-page":"F91","DOI":"10.1136\/fn.77.2.F91","article-title":"Improved outcome into the 1990s for infants weighing 500\u2013999 g at birth","volume":"77","author":"The Victorian Infant Collaborative Study Group","year":"1997","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2025090511173616000_95.3.F188.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70037-7"},{"key":"2025090511173616000_95.3.F188.3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1497"},{"key":"2025090511173616000_95.3.F188.4","doi-asserted-by":"publisher","DOI":"10.1136\/fn.88.1.F23"},{"key":"2025090511173616000_95.3.F188.5","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/S0140-6736(88)92300-8","article-title":"Survival of the smallest. 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