Publications by authors named "Catherine Deneux-Tharaux"

Objective: To compare the rates of bleeding recurrence and other post-partum haemorrhage (PPH)-related clinical outcomes in women with PPH initially controlled by intrauterine balloon tamponade (IUBT) according to its duration.

Design: Exploratory cohort study from a randomised trial.

Setting: Eighteen hospitals in France.

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Objective: To assess the association between maternal haemoglobinaemia in the immediate post-partum period and PPD symptoms 2 months after vaginal delivery.

Design: Ancillary cohort study of the TRAAP trial, a multicentre trial.

Setting: In France, 2015-2016.

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Background: An enhanced consideration of blood pressure (BP) dynamics during pregnancy could improve its monitoring. Distinct BP trajectories may exist, and some have been linked to adverse fetal development. Using maternal BP measurements spanning almost the entire pregnancy, this study aimed to identify trajectories and assess their association with birth outcomes.

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Objectives: To assess the incidence of hospital admissions for covid-19 disease in pregnant women, severity of covid-19 disease, and medical treatment provided to pregnant women with moderate to severe covid-19 during the first 10 months of the pandemic.

Design: Individual patient data meta-analysis of population based cohorts in International Obstetric Survey Systems.

Setting: 10 European countries with national or regional surveillance within the International Obstetric Survey Systems (INOSS) collaboration using aligned definitions and case report forms: Belgium, France (regional), Italy, the Netherlands, Denmark, Finland, Iceland, Norway, Sweden (regional), and the UK.

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Background: Placentas that are previa or low-lying are a major cause of severe postpartum hemorrhage (PPH). Tranexamic acid, by inhibiting the fibrinolytic pathway and protecting blood clots from degradation, is a promising drug for preventing blood loss after childbirth, especially in high-risk conditions. It remains unclear whether tranexamic acid would decrease the incidence of severe PPH among women with placentas that are previa or low-lying.

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Background: Population-based data are needed to reliably assess the impact of SARS-CoV-2 infection during pregnancy.

Objectives: To estimate the population-based incidence of SARS-CoV-2 infection and its severe forms in the obstetric population, identify risk factors of severe SARS-CoV-2 infection (severe COVID-19) and describe delivery, maternal and neonatal outcomes by disease severity, using a definition of severity based on organ dysfunction.

Methods: A prospective population-based study conducted over the three first pandemic waves between March 2020 and April 2021 in 281 maternity hospitals in six French regions included all women with SARS-CoV-2 infection during pregnancy or within 7 days post-partum, whether symptomatic or not, hospitalised or not.

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Background: Management and outcomes in women with placenta accreta spectrum grade 3 are rarely reported from population-based studies. The objective of this study is to describe profiles, management, and outcomes, of women with placenta accreta spectrum (PAS) grade 3 from three multiperiod studies.

Methods: This analysis used data from three multiperiod population-based cohort studies from the United Kingdom (UK) (May 2010-April 2011), France (November 2013-October 2015), and Italy (September 2014-August 2016) to compare the management and outcomes of women with grade 3 PAS.

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Background: Macrosomia, classically defined by an arbitrary birthweight threshold, is associated with an increased risk of postpartum hemorrhage. However, some preliminary evidence suggests that lower birthweights may also be at increased risk. We hypothesized that birthweight, analyzed as a continuous variable, is significantly associated with the risk of severe postpartum hemorrhage, with the risk increasing not only at higher birthweights traditionally associated with macrosomia but also potentially at lower birthweights.

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Introduction: The literature extensively documents neonatal and paediatric outcomes related to preterm delivery, but maternal health in this circumtances remains underexplored. This study aimed to identify women with antepartum severe maternal morbidity (SMM) among those delivering preterm and explore whether they delivered in hospitals with risk-appropriate maternal care facilities.

Material And Methods: Women giving birth at 22-34 weeks of gestation were identified from the French national prospective EPIPAGE-2 cohort study in 2011; terminations of pregnancy for fetal congenital malformations were excluded.

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Background: Postpartum anxiety (PPA) symptoms have harmful effects on child development and mother-infant interactions. Accordingly, in-depth knowledge of associated risk factors is crucial for prevention policies. This study aimed to estimate PPA symptom prevalence at 2 months and to identify associated risk factors in a representative sample of all women who gave birth in France in 2021, and in two subgroups: women with no postpartum depression (PPD) symptoms, and those with no history of mental health care.

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Objective: To evaluate the prevalence and risk factors of maternal dissatisfaction 2 days after a singleton vaginal delivery at or near term.

Methods: We conducted a planned ancillary cohort study of the TRanexamic Acid for Preventing Postpartum Hemorrhage After Vaginal Delivery (TRAAP) randomized controlled trial. Maternal dissatisfaction, related to the birth and to the subsequent hospital stay, was assessed 2 days postpartum by two self-administered questions: "Are you satisfied with the care you received during your child's birth?" and "Are you satisfied with the care you have received during your hospital stay?".

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Article Synopsis
  • * Of the women surveyed, 63% responded, revealing a postpartum depression prevalence of 16.4% when using a specific scoring scale (EPDS score of 13 or higher), which rose to 23.1% with a slightly lower cutoff (score of 11 or higher).
  • * Key risk factors identified included younger maternal age and being born in a non-European country, highlighting the need for tailored support and interventions for at-risk populations after cesarean delivery.
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Background: Tranexamic acid is a recommended treatment for women with a clinical diagnosis of postpartum haemorrhage, but whether it can prevent bleeding is unclear. We conducted a systematic review and individual patient data (IPD) meta-analysis of randomised controlled trials to assess the effects of tranexamic acid in women giving birth.

Methods: In this systematic review and IPD meta-analysis, we searched the WHO International Clinical Trials Registry Platform from database inception to Aug 4, 2024 for randomised trials that assessed the effects of tranexamic acid in women giving birth.

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Aims: To evaluate the impact of onset time, duration, and severity of various types of hypertensive disorders of pregnancy (HDP) on the risk of incident DM.

Methods: We used data from the ongoing French nationwide prospective cohort study CONCEPTION. We included all primiparous women in CONCEPTION who delivered between 2010 and 2018 (n = 2,816,793 women).

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Article Synopsis
  • Obstetric hemorrhage is a significant cause of maternal mortality that can be largely prevented, yet surgical injury during cesarean sections has become more common in France as a contributing factor to this issue.
  • A nationwide study analyzed maternal deaths from surgical injuries during cesareans in France from 2007 to 2018, revealing a concerning trend of increasing mortality ratios despite overall improvements in maternal health outcomes.
  • Key findings indicate that factors such as obesity, prior cesareans, and inadequate facilities played a significant role in these deaths, highlighting the need for improved care processes and risk factor management to enhance maternal safety.
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Article Synopsis
  • The study analyzed changes in the incidence and causes of maternal deaths due to obstetric hemorrhage in France from 2001 to 2015, focusing on the impact of national guidelines implemented in 2004 and updated in 2014.
  • Findings revealed a significant drop in the maternal mortality ratio (MMR) from 2.3 to 0.8 per 100,000 livebirths, with a notable decrease in deaths from uterine atony.
  • Despite improved clinical care, 88% of maternal deaths from hemorrhage were still considered preventable, highlighting areas needing further improvement in diagnosis and surgical management.
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Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.

Design: Systematic review and three-stage modified Delphi expert consensus.

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Article Synopsis
  • Eclampsia, a rare and serious complication of hypertensive disorders in pregnancy, shows an incidence of 2.8 per 10,000 births, highlighting its potential for being preventable with better care.
  • A study analyzed the care quality provided to women with eclampsia compared to those with severe maternal morbidity from non-eclamptic high blood pressure and found significant inadequacies in antenatal (39% inadequate), pre-eclampsia (76% inadequate), and eclampsia care (50% inadequate).
  • The findings indicate a critical need for improved, evidence-based standards for managing hypertensive disorders during pregnancy to prevent adverse outcomes for mothers and their babies.
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