Perinatal health inequalities and accessibility of maternity services in a rural French region: closing maternity units in Burgundy

Evelyne Combier , Hélène Charreire (1, 2) , Marc Le Vaillant , Francis Michaut , Cyril Ferdynus , Jeanne-Marie Amat-Roze , Jean-Bernard Gouyon , Catherine Quantin , Jennifer Zeitlin

1 LAB'URBA - LAB'URBA
2 CRESS - U1153 - Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle

Maternity unit closures in France have increased travel time for pregnant women in rural areas. We assessed the impact of travel time to the closest unit on perinatal outcomes and care in Burgundy using multilevel analyses of data on deliveries from 2000 to 2009. A travel time of 30min or more increased risks of fetal heart rate anomalies, meconium-stained amniotic fluid, out-of-hospital births, and pregnancy hospitalizations; a positive but non-significant gradient existed between travel time and perinatal mortality. The effects of long travel distances on perinatal outcomes and care should be factored into closure decisions.

Mots clés: Accessibility; Adolescent; Adult; Databases; Factual; Female; France; Health Facility Closure; Health Services Accessibility; Healthcare Disparities; Humans; Maternal Health Services; Maternity services; Medical Records; Middle Aged; Perinatal Care; Perinatal health; Pregnancy; Pregnancy Complications; Rural Health Services; Rural region; Travel time; Young Adult

Domaines: Santé publique et épidémiologie

Evelyne Combier, Hélène Charreire, Marc Le Vaillant, Francis Michaut, Cyril Ferdynus, et al.. Perinatal health inequalities and accessibility of maternity services in a rural French region: closing maternity units in Burgundy. Health & Place, 2013, 24, pp.225--233. ⟨10.1016/j.healthplace.2013.09.006⟩. ⟨hal-01393027⟩