Faced with the increase in prematurity, France wants to improve care

For several years, the number of premature births has been steadily increasing: to improve the daily life of often upset families, France intends to draw inspiration from the Swedish model and allow children to be cared for at home by medical teams.

Every year in France about 60,000 babies are born prematurely, ie before 37 weeks of amenorrhea (8 and a half months of pregnancy), or one every eight minutes.

Among these babies born before term, 85% are medium premature, 10% very premature (6 to 7 months of pregnancy) and 5% very very premature (under 6 months of pregnancy).

According to the results of the latest national perinatal survey, the rate of prematurity has been increasing for several years: it went from 4.5% in 1995 to 6% in 2016. Today it represents almost 8% of births, says the association. SOS préma, at the forefront of this matter.

There are several reasons: the first is that the age of pregnancy continues to decrease, but a late pregnancy generally presents greater risks for the baby.

In vitro fertilization, which could cause more complications, partly explains this increase as well.

The lifestyle of future mothers also comes into play: consumption of tobacco, alcohol, social precariousness, but also work stress and fatigue favor preterm births.

About half of these births result from a medical decision to terminate the pregnancy due to maternal or fetal pathology.

In this context, the Ministry of Health last month published a decree aimed at “improving the quality of life of the families of these infants who are often hospitalized for long periods”.

France would like to implement, initially in an experimental form, “an organizational model similar to that in force in Sweden and which gives very favorable results”.

It is a “home care of premature babies provided directly by the neonatology wards”, explain the ministry’s services.

– “Less stress” –

The child’s hospitalization time would thus be reduced: the parents would return home earlier with him and would be guided for care or feeding by medical personnel trained in the specific needs of these newborns.

Such support “would change everything”, rejoices Charlotte Bouvard, president of SOS préma, who campaigned with the French Society of Neonatology for this change in France.

“Studies have shown that it improves infant development and the parent-child relationship,” he explains. “In many cases, skin-to-skin + or breastfeeding, facilitated by the baby’s presence at home, is a cure in itself,” she continues.

Emmanuelle Bagout, 30, did not benefit from this opportunity. When she returned home, six weeks after the birth of her baby, born premature at 33 weeks, she felt not joy but “a great loneliness”.

“He spent almost a month in the neonatal ward, ate little, I went to visit him every day in the hospital”, remembers this Lyonnaise, three years after giving birth.

“When he left the service he weighed 2.3 kilos, only took a few grams a day, clearly lacking a sequel,” he regrets. “Having a nurse visit daily at home to reassure us would change everything,” she says.

The transfer of the neonatal ward to the parents’ home has only advantages, in the eyes of Pierre Kuhn, head of department in Strasbourg and one of the project leaders in France.

“In the Scandinavian countries that have implemented it, it has reduced hospital costs, enabled faster food empowerment, reduced risk of infection, decreased maternal stress and increased parental satisfaction,” he lists.

The French experiment, conducted over three years, will go through a tender to select a dozen teams. According to the ministry, “it will fuel reflection in view of a possible sustainability of the system”.

Leave a Comment