Résumé
In France, 15% of newborns between 24 and 30 weeks and 6 days are born outside a level 3 maternity unit. These newborns are referred to as "outborns." This situation is problematic to obstetric and pediatric teams and requires a postnatal transfer. Our primary objective was to identify the risk factors for outborn births in Occitanie. Our secondary objectives were to provide an overview of these births and assess their potential avoidability. Materials and Methods: we included all patients who gave birth to outborn newborns between 24 and 30 weeks and 6 days in Occitanie region in 2022. Our control group consisted of all patients who gave birth at that gestational age at Montpellier University Hospital in 2022. Outborn births were classified in three groups: potentially preventable, unavoidable with risk factors, and unavoidable without risk factors. Results: in 2022, 38 patients gave birth to 43 outborn newborns. The outborn rate was 9.6%. The most frequent reasons for consultation were uterine contractions and vaginal bleeding. The median admission-to-delivery time was 1 hour and 51 minutes. Risk factors included inadequate antenatal care (64% vs. 48%, p<0.05) and distance from a level 3 maternity hospital (55 km vs. 37 km, p<0.05). Infertility treatment was a protective factor (5.6% vs. 23%, p<0.05). After multivariate analysis, residing far from a level 3 maternity hospital and no infertility treatment remained significant risk factors. One birth was classified as potentially preventable, 12 as unavoidable with risk factors, and 30 as unavoidable without risk factors. Conclusion: the outborn birth rate in the Occitanie region is lower than the national rate. The identified risk factors highlight the importance of ensuring regular pregnancy follow-up for all patients and considering geographic distance in decision-making processes.