Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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58 Maternal Intensive Care in Belgium KCE Reports 94 Gestational age DISTRIBUTION OF GESTATIONAL AGE Table 25: Distribution of gestational age according to type of maternity Maternities without MICservices Maternities with MIC-services All 22-28 : Extreme prematurity 136 0.2% 427 1.5% 563 0.6% 29-32 : Very preterm 316 0.4% 679 2.5% 995 1.0% 33-36 : Preterm delivery 4,430 6.3% 2,128 7.7% 6,558 6.7% 37-42 : Term delivery 65,716 93.1% 24,383 88.3% 90,099 91.7% >=42 : Prolonged pregnancy 5 0.0% 4 0.0% 9 0.0% Missing information 9 7 16 All 70,612 100.0% 27,628 100.0% 98,240 100.0% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 Birth weight The maternities with a MIC-service deliver more women with premature neonates than the others (1.5% versus 0.2% for the extremely premature; 2.5% versus 0.4% for the very preterm; 7.7% versus 6.3% for the premature). The difference is statically significant; χ² test, p value < 0.0001. 24.5% of the extremely preterm babies and 31.8 % of the very preterm were born in a maternity without a MIC-service. DISTRIBUTION OF BIRTH WEIGHT Table 26: Distribution of birth weight according to type of maternity Maternities without MIC-services Maternities with MIC-services All 500 - 999 : Extreme low birth weight 103 0.1% 341 1.2% 444 0.5% 1000 - 1499 : Very low birth weight 188 0.3% 442 1.6% 630 0.6% 1500 - 2499 : Low birth weight 3,940 5.6% 2,164 7.8% 6,104 6.2% 2500 - 3999 : Normal birth weight 60,920 86.3% 22,828 82.6% 83,748 85.2% >=4000 : High birth weight 5,430 7.7% 1,805 6.5% 7,235 7.4% Missing information 31 48 79 All 70,612 100.0% 27,628 100.0% 98,240 100.0% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 The birth weight is tightly linked to the term of the newborn. The proportion of neonates with extremely low birth weight (ELBW) (1.2% versus 0.1%), of very low birth weight (VLBW)(1.6% versus 0.3%) and of low birth weight (7.8% versus 5.6%) is higher in the maternities with MIC-service than in the others. The difference is statistically significant; χ² test, p value < 0.0001. Overall 23.2% of the neonates with ELBW, 29.8% of the VLBW and 64.5% of the LBW (Low Birth Weight) were born in maternities without MIC-service.
KCE Reports 94 Maternal Intensive Care in Belgium 59 APGAR SCORES Table 27: Apgar scores at 1 and 5 minutes in the two types of maternities Apgar score at 1 minute Maternities without MICservices Maternities with MICservices All 0-3 1,317 1.9% 839 3.0% 2,156 2.2% 4-6 3,878 5.5% 1,660 6.0% 5,538 5.6% 7-10 65,409 92.6% 25,126 90.9% 90,535 92.2% Missing information 8 3 11 All 70,612 100.0% 27,628 100.0% 98,240 100.0% Apgar score at 5 minute 0-3 421 0.6% 320 1.2% 741 0.8% 4-6 818 1.2% 376 1.4% 1,194 1.2% 7-10 69,364 98.2% 26,927 97.5% 96.291 98.0% Missing information 9 5 14 All 70,612 100.0% 27,628 100.0% 98,240 100.0% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 Admissions The proportion of newborns with a low Apgar score (0-3) at 1 minute is higher in the maternities with MIC-services. The proportion of newborns with a low Apgar score (0- 3) at 5 minutes is also higher in the maternities with MIC-services. Nonetheless, the differences are slight. Apgar score are also linked to prematurity. PROPORTION OF ADMISSIONS TO NIC AND N* In maternities without MIC-service, 22.1% of the neonates are reported being admitted separately from their mother (0.4 % in NIC-service and 21.7% in N*- service). In maternities with MIC-services, 18.8% of the neonates are reported being admitted separately from the mother (14.7 % in NIC-service and 4.1% in N*-service). These results are shown in the table 28 below. Table 28: Proportion of neonates admitted to NIC and N* according to type of maternity Maternities without MIC-services Maternities with MIC-services All NIC 271 0.4% 4,093 14.7% 4,364 4.4% N* 15,307 21.7% 1,129 4.1% 16,436 16.7% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 The use of NIC or N*-services seems to depend highly from the availability of services. There are two maternities with NIC-service without a MIC-service. All the others have MIC- as well as NIC -beds. These isolated NIC-services admit 12.9 % of the newborns separately from their mother (10.7% in NIC and 2.2 in N*-service).
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Soins maternels intensifs (Maternal
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KCE Reports 94B Soins Maternels Int
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KCE Reports 94 Maternal Intensive C
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35. Etude relative aux coûts poten
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