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Ego A, Debillon T, Sourd D, Mitton N, Fresson J, Zeitlin J. Identifying Newborns with Hypoxic-Ischemic Encephalopathy in Hospital Discharge Data: A Validation Study. J Pediatr 2024; 268:113950. [PMID: 38336200 DOI: 10.1016/j.jpeds.2024.113950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/18/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
Hospital discharge databases (HDDs) are increasingly used for research on health of newborns. Linkage between a French population-based cohort of newborns with hypoxic-ischemic encephalopathy (HIE) and national HDD showed that the HIE ICD-10 code was not accurately reported. Our results suggest that HDD should not be used for research on neonatal HIE without prior validation of HIE ICD-10 codes.
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Affiliation(s)
- Anne Ego
- Public Health Department CHU Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP∗, TIMC-IMAG, Grenoble, France, ∗Institute of Engineering Univ, Grenoble Alpes; INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), FHU PREMA, Paris Descartes University, Paris, France; Univ. Grenoble Alpes, Inserm CIC1406, CHU de Grenoble, Grenoble, France.
| | - T Debillon
- Department of Neonatology CHU Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP∗, TIMC-IMAG, Grenoble, France, ∗Institute of Engineering Univ, Grenoble Alpes
| | - D Sourd
- Public Health Department CHU Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP∗, TIMC-IMAG, Grenoble, France, ∗Institute of Engineering Univ, Grenoble Alpes
| | - N Mitton
- Department of Bioinformatics CHU Grenoble Alpes, Univ. Grenoble Alpes, Grenoble, France
| | - J Fresson
- Population Health Office, DREES, Paris, France
| | - J Zeitlin
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), FHU PREMA, Paris Descartes University, Paris, France
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Auger N, Côté-Corriveau G, Kang H, Quach C, Lo E, Lee GE, Healy-Profitós J, Brousseau É, Luu TM. Multisystem inflammatory syndrome in 1.2 million children: longitudinal cohort study of risk factors. Pediatr Res 2024; 95:325-333. [PMID: 37198405 PMCID: PMC10191400 DOI: 10.1038/s41390-023-02633-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND We identified patient characteristics associated with an increased risk of developing MIS-C. METHODS We conducted a longitudinal cohort study of 1,195,327 patients aged 0-19 years between 2006 and 2021, including the first two waves of the pandemic (February 25-August 22, 2020 and August 23, 2020-March 31, 2021). Exposures included prepandemic morbidity, birth outcomes, and family history of maternal disorders. Outcomes included MIS-C, Kawasaki disease, and other Covid-19 complications during the pandemic. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between patient exposures and these outcomes using log-binomial regression models adjusted for potential confounders. RESULTS Among 1,195,327 children, 84 developed MIS-C, 107 Kawasaki disease, and 330 other Covid-19 complications during the first year of the pandemic. Prepandemic hospitalizations for metabolic disorders (RR 11.3, 95% CI 5.61-22.6), atopic conditions (RR 3.34, 95% CI 1.60-6.97), and cancer (RR 8.11, 95% CI 1.13-58.3) were strongly associated with the risk of MIS-C, compared with no exposure. These same exposures were also associated with Kawasaki disease and other Covid-19 complications. However, birth characteristics and history of maternal morbidity were not associated with MIS-C development. CONCLUSIONS Children with pre-existing morbidity have a considerably elevated risk of MIS-C. IMPACT Morbidities that predispose children to multisystem inflammatory syndrome (MIS-C) are unclear. In this study, prepandemic hospitalizations for metabolic disorders, atopic conditions, and cancer were associated with an elevated risk of MIS-C. Birth characteristics and family history of maternal morbidity were not, however, associated with MIS-C. Pediatric morbidities may play a greater role in MIS-C onset than maternal or perinatal characteristics, and may help clinicians better recognize children at risk for this complication.
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Affiliation(s)
- Nathalie Auger
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada.
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Gabriel Côté-Corriveau
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Harb Kang
- Department of Rheumatology, Cité-de-la-Santé Hospital, Laval, QC, Canada
| | - Caroline Quach
- Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Montreal, QC, Canada
- Infection Prevention and Control, Clinical Department of Laboratory Medicine, Sainte-Justine Hospital Research Centre, Montreal, QC, Canada
| | - Ernest Lo
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Ga Eun Lee
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jessica Healy-Profitós
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Émilie Brousseau
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
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Levaillant M, Garabédian C, Legendre G, Soula J, Hamel JF, Vallet B, Lamer A. In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn: Contribution from a French nationwide study. Int J Gynaecol Obstet 2024; 164:210-218. [PMID: 37485702 DOI: 10.1002/ijgo.15004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To investigate maternal and neonatal outcomes after a delivery in France in 2019, according to hospital characteristics and the impact of distance and time of travel on mother and newborn. METHODS All parturients above 18 years of age who delivered in 2019 and were identified in the French health insurance database were included, with their newborns, in this retrospective cohort study. Main outcome measures were Severe Maternal Morbidity score and the Neonatal Adverse Outcome Indicator (NAOI). RESULTS Among the 733 052 pregnancies included, 10 829 presented a severe maternal morbidity (1.48%) and 77 237 had a neonatal adverse outcome (10.4%). Factors associated with an unfavorable maternal or neonatal outcome were Obstetric Comorbidity Index, primiparity, and cesarean or instrumental delivery. Prematurity was associated with less severe maternal morbidity but more neonatal adverse outcomes. Time of travel above 30 min was associated with a higher NAOI rate. CONCLUSIONS Results suggest the efficiency of regionalization of perinatal care in France, although a difference in both outcomes persists according to unit volume, suggesting the need for a further step in concentrating perinatal care. Perinatal care organization should focus on mapping the territory with high-level, high-volume maternity throughout the territory; this suggests closing down high-volume units and improving low-volume ones to maintain coherent mapping.
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Affiliation(s)
- Mathieu Levaillant
- Université Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
- Methodology and Biostatistics Department, Angers University Hospital, University of Angers, Angers, France
| | | | - Guillaume Legendre
- Faculté de Santé, Département de Médecine, CHU d'Angers, Angers, France
- Service de Gynécologie-Obstétrique, CHU d'Angers, Angers, France
| | - Julien Soula
- Université Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Jean-François Hamel
- Methodology and Biostatistics Department, Angers University Hospital, University of Angers, Angers, France
- UMR_S1085, University of Angers, CHU Angers, University of Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), Angers, France
| | - Benoît Vallet
- Université Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Antoine Lamer
- Université Lille, CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
- F2RSM Psy - Fédération Régionale de Recherche en Psychiatrie et Santé Mentale Hauts-de-France, Lille, France
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