On October 11, 2017, the first results of the French national perinatal survey 2016 were published. The report shows an increase in delaying child bearing until later in life, and an increase in the number of premature babies.
Periodically, these surveys are carried out by “Inserm” * and “DREES” **, with the latest one dating from 2010. They provide detailed information on pregnancy and childbirth. The March 2016 data includes reports of 14,142 births, from both metropolitan France and its overseas departments and territories.
In metropolitan France, certain risk factors have increased:
Besides the preoccupying fact that obesity is on the rise, the cumulative report emphasizes that “As noted for the past several decades, child bearing is being increasingly postponed until later in life, even though it is also well-documented that this greatly raises the risks for both mother and child.” For example the number of women in the ≥ 35 year-old group who postpone having a child has increased from 19% in 2010, up to 21% in 2016. Likewise, the statistics of infants born either with low weight and/or prematurely has risen from 1995 to a level of 6% in 2016: “Insofar as other countries have either reported a steadfast low or declining rates, these current French results raise issues for discussion.” Those who chose exclusively to breastfeed declined to 52% compared to 60% in 2010.
Job situations for both women and their partners have deteriorated: with 28% of households benefitting from various subsidies allotted during pregnancy such as those for unemployment or low income.
The investigation shows how certain public health guidelines are being are applied. For an uncomplicated pregnancy, no more than 3 sonograms are usually recommended. But in 2016, 75% of women had more than 3, and 36% had 6 sonograms. Following changes in screening procedures for Trisomy 21, also known as Down syndrome, the numbers of trophoblast biopsies stabilized, and the number of amniocentesis performed fell from 8.7% in 2010 to 3.6% in 2016. As usual in these reports, the screening procedures target Trisomy 21, thus a sign of ongoing apprehensions as far as this disorder is concerned.
Since the risk factors are higher in the French overseas regions and territories, the data for perinatal health is more preoccupying. Compared to the French mainland, there are numerous women in “dire straits”, or poorer living conditions.
Hospitalizations for complications experienced during pregnancy are more commonplace, often because of irregular clinical follow-up. In mainland France only 5% of women live alone, whereas in these overseas territories 25% of pregnant women do not have a partner. In the mainland, the 18-19 year-olds account for 2% of pregnancies, compared to 6%. A higher rate of premature births has been demonstrated as well.
Private maternity clinics are still on the decline (517 in France and 20 in the metropolis), in favor of larger maternity wards, which are thought to provide greater health and safety by increasing offering readily-available services from obstetricians, anesthetists and pediatricians. Comforting women during delivery appears to be more individualized, and including improved pain treatment.
*Inserm: National Health and Medical Research Institute
**DREES: Directorate for Research, Studies, Evaluation and Statistics