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Master Thesis

Impact de la fermeture des maternités du réseau Normandie Occidentale sur la distance domicile-maternité, sur le taux d'accouchements extrahospitaliers, d'outborns et de morts foetales in utero

Abstract : Introduction: The regionalization of perinatal care with the reorganization of the health care offer has resulted in the closure of four maternities in the Normandie Occidentale network The aim of our study is to study the impact of the closure of maternity hospitals in the area of Western Normandy on the increase of the home and maternity’s distance, on the number of out-of-hospital deliveries, on the outborns and on the occurrence of fetal deaths in utero. Materials and Methods: The study population represents women who gave birth in the area between January 2011 and August 2020. Calculation of home-maternity distances from the centroid of each geographic sector with distance and time measurement to the nearest maternity hospital. Calculation of the outborn rate, fetal deaths in utero rate, out-of-hospital deliveries rate over the various periods impacted by maternity closures. Results: Increased travel time from 19 to 21 minutes, the journey distance goes from 17 to 19 kms. The increase in distance is significant for some areas up to 34kms. There is a significant increase in the rate of out-of-hospital deliveries from 2.11 to 4.04% (p<103), this rate is not significantly increased in areas where the distance has increased by more than 5 km. There is no significant increase in the outborn rate (10%) and the number of fetal deaths in uteros (5 ‰) over the study period. Conclusion: The increase in the home-maternity distance is linked with an increase in out-of-hospital deliveries but does not appear to impact outborns and the rate of fetal deaths in utero.
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https://dumas.ccsd.cnrs.fr/dumas-03534761
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Submitted on : Wednesday, January 19, 2022 - 3:38:40 PM
Last modification on : Monday, January 24, 2022 - 3:23:08 AM
Long-term archiving on: : Wednesday, April 20, 2022 - 6:59:55 PM

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Maxime Trupheme. Impact de la fermeture des maternités du réseau Normandie Occidentale sur la distance domicile-maternité, sur le taux d'accouchements extrahospitaliers, d'outborns et de morts foetales in utero. Médecine humaine et pathologie. 2021. ⟨dumas-03534761⟩

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