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Nunes I, Dupont C, Timonen S, Ayres de Campos D, Cole V, Schwarz C, Kwee A, Yli B, Vayssiere C, Roth GE, Gliozheni E, Savochkina Y, Ivanisevic M, Janku P, Timonen S, Daskalakis G, Beke A, Santo S, Druškovič M, Duvekot JJ, Farr A, Dreyfus M. European Guidelines on Perinatal Care - Oxytocin for induction and augmentation of labor[Formula: see text]. J Matern Fetal Neonatal Med 2021; 35:7166-7172. [PMID: 34470113 DOI: 10.1080/14767058.2021.1945577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OF RECOMMENDATIONS1. Oxytocin for induction or augmentation of labor should not be started when there is a previous scar on the body of the uterus (such as previous classical cesarean section, uterine perforation or myomectomy when uterine cavity is reached) or in any other condition where labor or vaginal delivery are contraindicated. (Moderate quality evidence +++-; Strong recommendation).2. Oxytocin should not be started before at least 1 h has elapsed since amniotomy, 6 h since the use of dinoprostone (30 min if vaginal insert) and 4 h since the use of misoprostol (Low quality evidence ++- -; Moderate recommendation).3. Cardiotocography (CTG) should be performed and a normal pattern without tachysystole should be documented for at least 30 min before oxytocin is used. Continuous CTG, with adequate monitoring of both fetal heart rate and uterine contractions, should be maintained for as long as oxytocin is used, and thereafter until delivery (Low ++- - to moderate +++- quality evidence; Strong recommendation).4. For labor induction, at least 1-h should be allowed after amniotomy before oxytocin infusion is started, to evaluate whether adequate uterine contractility has meanwhile ensued. For augmentation of labor, if the membranes are intact and there are conditions for a safe amniotomy, the latter should be considered before oxytocin is started (Very low quality evidence +- --; Weak recommendation).5. Oxytocin should be administered intravenously using the following regimen: 5 IU oxytocin diluted in 500 mL of 0.9% normal saline (NaCl) (each mL contains 10 mIU of oxytocin), in an infusion pump at increasing rates, as shown in Table 1, until a frequency of 3-4 contractions per 10 min is reached, a non-reassuring CTG pattern ensues, or maximum rates are reached (Low quality evidence ++ - -; Strong recommendation). If the frequency of contractions exceeds 5 in 10 min, the infusion rate should be reduced, even if a normal CTG pattern is present. With a non-reassuring CTG pattern, urgent clinical assessment by an obstetrician is indicated, and strong consideration should be given to reducing or stopping the oxytocin infusion. The minimal effective dose of oxytocin should always be used. (Low ++- - to Moderate +++- - quality evidence; Strong recommendation).[Table: see text]6. Use of oxytocin for induction and augmentation of labor should be regularly audited (Low quality evidence ++--; Strong recommendation).
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Affiliation(s)
| | - Inês Nunes
- School of Medicine and Biomedical Sciences (ICBAS), University Hospital Center of Porto, CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Corinne Dupont
- University Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE) INSERM U1290; AURORE Perinatal Network, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Susanna Timonen
- Finnish Society of Perinatology, Turku University Hospital, Turku University, Turku, Finland
| | | | | | | | - Christiane Schwarz
- Dept. Midwifery Science, University Lubeck, Institute for Health Sciences, Lubeck, Germany
| | - Anneke Kwee
- Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Branka Yli
- Delivery Deparment, Oslo University Hospital, Oslo, Norway
| | - Christophe Vayssiere
- Department of Obstetrics and Gynecology, Paule de Viguier Hospital, CHU Toulouse; UMR1295 CERPOP (Centre for Epidemiology and Population Health Research), Team SPHERE (Study of Perinatal, Paedriatric and Adolescent Health: Epidemiological Research and Evaluation) Toulouse III University, Toulouse, France
| | | | - Elko Gliozheni
- Albanian Association of Perinatology, Department of Obstetrics and Gynecology, University Hospital of Obstetrics and Gynaecology 'Koco Gliozheni', Tirana, Albania
| | - Yuliya Savochkina
- Bielorussian Society of Human Reproduction, 5th Minsk City Hospital and Belarus Medical Academy of Postgraduate Education, Minsk, Belarus
| | - Marina Ivanisevic
- Croatian Association of Perinatal Medicine, University Clinic for Obstetrics and Gynecology, School of Medicine, Zagreb, Croatia
| | - Petr Janku
- Czech Society of Perinatology and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, University Hospital Brno, Masaryk University Brno, Brno, Czech Republic; Department of Nursing and Midwifery, Masaryk University Brno, Czech Republic
| | - Susanna Timonen
- Finnish Society of Perinatology, Turku University Hospital, Turku University, Turku, Finland
| | - George Daskalakis
- Hellenic Society of Perinatal Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Artur Beke
- Hungarian Society of Perinatology and Obstetric Anesthesiology, Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Susana Santo
- Portuguese Society of Obstetrics and Maternal-Fetal Medicine, Santa Maria Hospital, University of Lisbon Medical School, Lisbon, Portugal
| | - Mirjam Druškovič
- Slovenia Medical Association - Society of Perinatal Medicine, Division of Obstetrics and Gynecology, UMC Ljubljana, Ljubljana, Slovenia
| | - J J Duvekot
- Dutch Society of Obstetrics and Gynecology, Department of Obstetrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Alex Farr
- Austrian Society for Pre- and Perinatal Medicine, Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Michel Dreyfus
- Societé Française de Medicine Perinatale, Service d'Obstétrique, Gynécologie et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, Caen, France
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Clark RRS, Warren N, Shermock KM, Perrin N, Lake E, Sharps PW. The Role of Oxytocin in Primary Cesarean Birth Among Low-Risk Women. J Midwifery Womens Health 2020; 66:54-61. [PMID: 32930507 DOI: 10.1111/jmwh.13157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To examine whether there is a threshold of oxytocin exposure at which the risk for primary cesarean increases among women who are nulliparous with a term, singleton, vertex fetus (NTSV) and how oxytocin interacts with other risk factors to contribute to this outcome. METHODS This was a secondary analysis of the Consortium on Safe Labor data set that used a retrospective cohort study design. Women who met the criteria for NTSV who were not admitted for a prelabor cesarean and for whom oxytocin data were available, were included in the sample. Robust logistic regression was used to examine the association of oxytocin exposure with primary cesarean birth, while controlling for demographic and clinical risk factors and clustering by provider. RESULTS The sample comprised 17,331 women who were exposed to oxytocin during labor. The women were predominantly white non-Hispanic (59.2%) with an average (SD) gestational age of 39.4 (1.1) weeks and an 18.5% primary cesarean rate. Exposure to greater than 11,400-milliunits (mU) of oxytocin resulted in 1.6 times increased odds of primary cesarean birth compared with less than 11,400 mU (95% CI 1.01-2.6). DISCUSSION Exposure to greater than 11,400 mU of oxytocin in labor was associated with an increased odds of primary cesarean birth in NTSV women.
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Affiliation(s)
- Rebecca R S Clark
- Center for Health Outcomes and Policy Research, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.,Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
| | - Nicole Warren
- Department of Community and Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Kenneth M Shermock
- Center for Medication Safety and Quality, Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland.,Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nancy Perrin
- Biostatistics and Methods Core, Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Eileen Lake
- Center for Health Outcomes and Policy Research, Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.,Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania
| | - Phyllis W Sharps
- Department of Community and Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland
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Blanc-Petitjean P, Legardeur H, Meunier G, Mandelbrot L, Le Ray C, Kayem G. Evaluation of the implementation of a protocol for the restrictive use of oxytocin during spontaneous labor. J Gynecol Obstet Hum Reprod 2019; 49:101664. [PMID: 31811971 DOI: 10.1016/j.jogoh.2019.101664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/28/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Use of oxytocin is associated with uterine hyperstimulation and postpartum hemorrhage with a dose-dependent effect. We aimed to evaluate the effect of the implementation of a protocol for the restrictive use of oxytocin during spontaneous labor on obstetric and neonatal outcomes. MATERIAL AND METHODS We performed an observational before-and-after study among 2174 women in spontaneous labor with a term singleton cephalic fetus. Obstetric and neonatal outcomes were compared according to the period, before (period A) and after (period B) the implementation of a protocol for the restrictive use of oxytocin. RESULTS 1235 women were included in period A and 939 in period B. Compared to period A, the use of oxytocin during period B was significantly lower (45.5 vs. 35.1%, p<0.001) in both nulliparous (61.2 vs 54.6%, p=0.04) and multiparous women (34.0 vs. 21.1%, p<0.001). Labor was significantly longer in period B, both in nulliparous (6.7 vs. 7.9 h, p<0.01) and multiparous women (4.1 vs. 4.5 h, p<0.01). A lower frequency of uterine hyperstimulation (6.6 vs. 2.7%, p=0.01) was observed in period B. The odds of instrumental and cesarean delivery were not different between the periods (respectively adjusted odds ratio (AOR), 95% confidence interval (CI), 1.1(0.8-1.4); 1.2(0.8-1.8)) including for nulliparous women (respectively, 1.3(0.9-1.7); 1.3(0.8-1.9)). DISCUSSION Reducing the use of oxytocin during spontaneous labor through the implementation of a protocol may reduce the iatrogenic effects without increasing the risk of caesarean section but this implies longer duration of labor.
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Affiliation(s)
- Pauline Blanc-Petitjean
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, 75014, Paris, France; Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Obstetrics and Gynecology, DHU Risks in pregnancy, 92700, Colombes, France.
| | - Hélène Legardeur
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Obstetrics and Gynecology, DHU Risks in pregnancy, 92700, Colombes, France
| | - Géraldine Meunier
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, 75014, Paris, France; Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Obstetrics and Gynecology, DHU Risks in pregnancy, 92700, Colombes, France
| | - Laurent Mandelbrot
- Assistance Publique-Hôpitaux de Paris, Louis Mourier Hospital, Department of Obstetrics and Gynecology, DHU Risks in pregnancy, 92700, Colombes, France
| | - Camille Le Ray
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, 75014, Paris, France; Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Port Royal Maternity Unit, DHU Risks in Pregnancy, 75014, Paris, France
| | - Gilles Kayem
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, 75014, Paris, France; Assistance Publique-Hôpitaux de Paris, Trousseau Hospital, Department of Obstetrics and Gynecology, 75012, Paris, France
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Barasinski C, Vendittelli F. Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 3: Interventions associated with oxytocin administration during spontaneous labor. J Gynecol Obstet Hum Reprod 2017; 46:489-497. [DOI: 10.1016/j.jogoh.2017.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Dupont C, Carayol M, Le Ray C, Deneux-Tharaux C, Riethmuller D. Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Guidelines short text. J Gynecol Obstet Hum Reprod 2017; 46:539-543. [DOI: 10.1016/j.jogoh.2017.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Coulm B, Tessier V. Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 4: Oxytocin efficiency according to implementation in insufficient spontaneous labor. J Gynecol Obstet Hum Reprod 2017; 46:499-507. [PMID: 28526519 DOI: 10.1016/j.jogoh.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B Coulm
- Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité (CRESS), University Hospital Department "Risks in Pregnancy", université Paris Descartes, 53, avenue de l'Observatoire, 75014 Paris, France.
| | - V Tessier
- University Hospital Department "Risks in Pregnancy", AP-HP, HUPC-AP-HP, 53, avenue de l'Observatoire, 75014 Paris, France.
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Dupont C, Carayol M, Le Ray C, Deneux-Tharaux C, Riethmuller D. Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Introduction and methodology. J Gynecol Obstet Hum Reprod 2017; 46:465-467. [PMID: 28473288 DOI: 10.1016/j.jogoh.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C Dupont
- AURORE perinatal network, 69004 Lyon, France; Pôle IMER, Lyon university hospital, 69003 Lyon, France; EA 7425, Health Services and Performance Research (HESPER), University Lyon, Claude-Bernard Lyon 1 University, 69008 Lyon, France.
| | - M Carayol
- Mother and child protection services, Paris Direction of Family and Early Childhood, Paris City Hall, 75196 Paris, France
| | - C Le Ray
- Port-Royal Maternity Unit, Cochin Hospital, AP-HP, DHU Risks in Pregnancy, Paris Descartes University, 75014 Paris, France; Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in pregnancy, Paris Descartes University, 75014 Paris, France
| | - C Deneux-Tharaux
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in pregnancy, Paris Descartes University, 75014 Paris, France
| | - D Riethmuller
- Besançon University Hospital, 3, boulevard Fleming, 25000 Besançon, France
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Dupont C, Carayol M, Le Ray C, Barasinski C, Beranger R, Burguet A, Chantry A, Chiesa C, Coulm B, Evrard A, Fischer C, Gaucher L, Guillou C, Leroy F, Phan E, Rousseau A, Tessier V, Vendittelli F, Deneux-Tharaux C, Riethmuller D. Recommandations pour l’administration d’oxytocine au cours du travail spontané. Texte court des recommandations. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.sagf.2016.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Coulm B, Tessier V. Recommandations pour l’administration d’oxytocine au cours du travail spontané. Chapitre 4 : efficacité de l’oxytocine au cours du travail spontané selon les modalités d’administration. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.sagf.2016.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Dupont C, Carayol M, Le Ray C, Barasinski C, Beranger R, Burguet A, Chantry A, Chiesa C, Coulm B, Evrard A, Fischer C, Gaucher L, Guillou C, Leroy F, Phan E, Rousseau A, Tessier V, Vendittelli F, Deneux-Tharaux C, Riethmuller D. [Oxytocin administration during spontaneous labour: Guidelines for clinical practice. Guidelines short text]. ACTA ACUST UNITED AC 2017; 45:56-61. [PMID: 28238320 DOI: 10.1016/j.gofs.2016.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation. Rate of cervical dilatation is considered as abnormal below 1cm per 4hour during the first part of the active phase, and below 1cm per 2hours above 7cm of dilatation. During the latent phase of the first stage of labor, i.e. before 5cm of cervical dilatation, it is recommended that an amniotomy not be performed routinely and not to use oxytocin systematically. It is not recommended to expect the active phase of labor to start the epidural analgesia if patient requires it. If early epidural analgesia was performed, the administration of oxytocin must not be systematic. If dystocia during the active phase, an amniotomy is recommended in first-line treatment. In the absence of an improvement within an hour, oxytocin should be administrated. However, in the case of an extension of the second stage beyond 2hours, it is recommended to administer oxytocin to correct a lack of progress of the presentation. If dynamic dystocia, it is recommended to start initial doses of oxytocin at 2mUI/min, to respect at least 30min intervals between increases in oxytocin doses delivered, and to increase oxytocin doses by 2mUI/min intervals without surpassing a maximum IV flow rate of 20mUI/min. The reported maternal adverse effects concern uterine hyperstimulation, uterine rupture and post-partum haemorrhage, and those of neonatal adverse effects concern foetal heart rate anomalies associated with uterine hyperstimulation, neonatal morbidity and mortality, neonatal jaundice, weak suck/poor breastfeeding latch and autism. CONCLUSION The widespread use of oxytocin during spontaneous labour must not be considered as simply another inoffensive prescription without any possible deleterious consequences for mother or foetus. Conditions for administering the oxytocin must therefore respect medical protocols. Indications and patient consent have to be report in the medical file.
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Affiliation(s)
- C Dupont
- Pôle IMER, Réseau périnatal Aurore, hospices civils de Lyon, 69003 Lyon, France; HESPER EA 7425, université Lyon, université Claude-Bernard-Lyon 1, 69008 Lyon, France.
| | - M Carayol
- Service de PMI, direction des familles et de la petite enfance, mairie de Paris, 75196 Paris, France
| | - C Le Ray
- Maternité Port Royal, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - C Barasinski
- EA 4681 PEPRADE, université d'Auvergne, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - R Beranger
- Inserm U1085, IRSET, équipe 9 « recherches épidémiologiques sur l'environnement, la reproduction et le développement », 35000 Rennes, France
| | | | - A Chantry
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France; École de sages-femmes Baudelocque, université Paris Descartes, DHU risques et grossesse, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - C Chiesa
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - B Coulm
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - A Evrard
- Association bien naître, 69003 Lyon, France
| | - C Fischer
- Maternité Port Royal, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - L Gaucher
- HESPER EA 7425, université Lyon, université Claude-Bernard-Lyon 1, 69008 Lyon, France; Hôpital Femme-Mère-Enfant, hospices civils de Lyon, 69500 Bron, France; Pôle information médicale évaluation recherche, 69003 Lyon, France
| | - C Guillou
- Clinique Natecia, 69008 Lyon, France
| | - F Leroy
- Hôpital Montélimar, 26200 Montélimar, France
| | - E Phan
- Association d'usagers, collectif inter-associatif autour de la naissance (CIANE), 75014 Paris, France
| | - A Rousseau
- Département de Maïeutique, UFR des sciences de la santé Simone-Veil, université Versailles-Saint-Quentin, 78000 Versailles, France
| | - V Tessier
- Département hospitalo-universitaire « risques et grossesse », groupe hospitalier Cochin, AP-HP, 53, avenue de l'Observatoire, 75014 Paris, France
| | - F Vendittelli
- EA 4681 PEPRADE, université d'Auvergne, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - C Deneux-Tharaux
- Inserm U1153, épidémiologie obstétricale, périnatale et pédiatrique (équipe EPOPé), centre de recherche en épidémiologie et statistiques Sorbonne Paris Cité (CRESS), DHU risques et grossesse, université Paris Descartes, 75014 Paris, France
| | - D Riethmuller
- Pôle Mère-Femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
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