Clinical trial NCT05684419: Preterm Infants Born to Homeless Mothers.
Official title: Observation of the Fate and Quality of Medical Follow-up of Children Born Preterm to Homeless Mothers.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Prematurity; Extreme
Keywords: Premature
Homeless
Extreme prematurity
Lead sponsor: Hôpital NOVO
Sponsor class: OTHER
First posted: 2023-01-13
Enrollment: 50
Sex: ALL
Maximum age (years): 33
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All infants born at or below 33SA:

* Born between January 2019 and December 2021
* At the René Dubos Hospital in Pontoise
* Whose mother did not have a fixed address at the time of discharge.

Brief summary: In recent years, the number of homeless patients who are accommodated by the SAMU social has increased. These patients are in a situation of financial, but also often social and psychological precariousness. The literature already shows us that precariousness and homelessness are a risk factor for prematurity, but also for the patients themselves, a risk of more frequent recourse to emergency services and of late consultation for advanced pathologies.

The objective of this study is to evaluate the fate and quality of medical follow-up of children born very premature (≤33SA) to homeless mothers.

Detailed description: The hospital of Pontoise is the largest maternity hospital in the department (Val d'Oise, 95) with 4449 births in 2021. It has a type 3 neonatal intensive care unit where approximately 150 premature babies under 32 weeks of age are hospitalized each year, including 80 premature babies under 28 weeks of age. These children require a specific and prolonged follow-up after hospitalization, including medical consultations to evaluate their neurodevelopmental development, but also the prevention of RSV infection (Respiratory Syncitial Virus).

In recent years, the number of homeless patients who are accomodated by the SAMU social has increased. These patients are in a precarious financial, but also often social and psychological situation. The literature already shows us that precariousness and homelessness are a risk factor for prematurity, but also for the patients themselves, a risk of more frequent recourse to emergency services and late consultation with advanced pathologies.

The aim of this study is to evaluate the fate and quality of medical follow-up of children born very premature (≤33SA) to homeless mothers, by answering the following questions:

* What about the follow-up of their very premature child?
* How does the department organize itself to ensure optimal follow-up for these patients?

Eligibility criteria: Inclusion Criteria :

All infants born at or below 33SA:

* Born between January 2019 and December 2021
* At the René Dubos Hospital in Pontoise
* Whose mother did not have a fixed address at the time of discharge.

NB: Mothers who do not read French well will have the study explained to them by the doctor who follows their child during a consultation, or by telephone.

Exclusion Criteria :

- Opposition of the mothers

Primary outcomes:
measure: Assessment of the rate of infants born to homeless mothers at or below 33 SA and lost to follow-up for extreme prematurity
timeFrame: At 12 month
Secondary outcomes:
measure: Assessment of the compliance of homeless mothers with medical prescriptions and the respect of the instructions given for the course of care (treatments, physiotherapy, appointment scheduling, etc.)
timeFrame: At 12 month
measure: Assessment of vaccination rates in infants born at or below 33 days' gestation to homeless mothers
timeFrame: At 12 month
measure: Assessment of the organized follow-up in the city of infants born at a term less than or equal to 33 days of age, of homeless mothers (between the PMI and the attending physicians)
timeFrame: At 6 month
measure: Assessment of the rate of re-hospitalization and consultation in the emergency room of the René Dubos Hospital for infants born at a term less than or equal to 33 days of age, of homeless mothers
timeFrame: At 12 month
measure: Assessment of breastfeeding duration at 6 months in infants born at or below 33 days' gestation to homeless mothers
timeFrame: At 6 month
measure: Assessment of the type of feeding on the duration of follow-up in infants born at a term less than or equal to 33 SA, of homeless mothers
timeFrame: At 12 month
measure: Assessment of staturo-weight growth during follow-up in infants born at or below 33 SA born to homeless mothers
timeFrame: At 12 month
Other outcomes:
Locations:
city: Pontoise
country: France
facility: Resuscitation and neonatal medicine department - Centre Hospitalier René Dubos
Study officials:
affiliation: Hôpital NOVO
name: Dr Suzanne BORRHOMEE
role: PRINCIPAL_INVESTIGATOR
References: