a groundbreaking report to describe and improve the health status of women and newborns

The first photograph of perinatal health in France

The analyzes presented were carried out by Public Health France within the framework of their mission to monitor the health status of the population. For the first time, this report presents the elements of knowledge necessary for a global overview and understanding of perinatal health at the national level. It is part of the first 1000 days strategy, which enables decision-makers as well as parents and stakeholders to provide useful knowledge to better target public health interventions and measures to prevent and promote health. The presented indicators aim to describe the health status and socio-demographic characteristics of mothers, risk factors, pregnancy monitoring and delivery practices, and the child’s health status during childbirth and breastfeeding.
The published data predates the COVID-19 outbreak, which is the subject of special investigations. This report is intended to be updated regularly for the information needs of the perinatal health surveillance system. A selection of the indicators published in this report is also available in open data on the Géodes portal of the French Public Health.

The evolution of certain indicators testifies to a globally worrying situation in France regarding perinatal health, such as the increase in neonatal mortality, which should be better understood in order to prevent this trend in the coming years. Sociodemographic indicators confirm a decline in the birth rate in all regions of France, except Guyana, and an average maternal age at childbirth (30.2 years in 2019) that continues to increase in all regions. Certain maternal pathologies increase during pregnancy and postpartum; hypertensive disorders (4.5% in 2010 to 5.0% in 2019) and gestational diabetes (6.7% in 2010 to 13.6% in 2019). This recent increase is partly explained by changes in screening methods and also by the prevalence of risk factors such as obesity or older maternal age. The obstetrical practices examined in this report show a significant decrease in the frequency of episiotomies (from 29.5% in 2010 to 10.0% in 2019 among primipars with non-instrumental vaginal delivery) and stability in referral rates. caesarean section (about 20%).

Special attention is paid to foreign departments

This report provides an overview of large regional disparities and aims to provide an important data base for measures to reduce social inequalities in health that emerge and widen from the earliest years of life.
This shows that health outcomes in the DROMs are generally more unfavorable there than in mainland France: the maternal mortality rate is 4 times higher than in mainland France, the stillbirth rate is 1.5 times higher and the neonatal mortality rate (0 to 0 deaths at 27 days of life) twice as high.

However, the situation is heterogeneous among DROMs. Reunion Island, Martinique and Guadeloupe are characterized by a situation approaching that of mainland France in certain indicators of pregnancy monitoring. In these areas, other indicators differ from mainland France, such as more frequently detected risk factors (diabetes during pregnancy, hypertensive disorders during pregnancy) or health indicators, especially preterm birth and perinatal death). Guyana and Mayotte are the most disadvantaged departments. Mothers in Guyana are generally in precarious situations (one-third of births not covered by health insurance, about one-quarter of women in irregular situations and benefiting from AME) and have less supervision during their pregnancies. The socio-demographic characteristics of mothers in Mayotte are specific (young mothers, higher birth rate, two-thirds without social security) partly explained by significant immigration from Comoros.

Findings from the data analysis call for strengthening perinatal health prevention and promotion to support mothers and families throughout pregnancy, and better access to rights and care, particularly in specific areas including DROMs. The gradient of social inequalities in health, which is an important indicator of adverse pregnancy outcomes, should be a priority criterion for guiding all measures to improve the health of women and their children.

“These results provide for the first time an overview of perinatal health in France. The indicators published today describe a worrying and heterogeneous situation in perinatal health during the period before the Covid-19 pandemic. The update every two years will make it possible to follow the evolution of these indicators. and guide public policy. This knowledge base forms the basis of all preventive measures favorable to the health of the unborn child and future children. Deployment of interventions to promote parental health and attachment (PANJO).”

  • Pr Geneviève Chêne, French Director General of Public Health

Public Health France’s action program in perinatal and early childhood health

Since its creation in May 2016, Public Health France has made an important commitment to perinatal, early childhood and childhood health. The agency is responsible for coordinating the perinatal surveillance system in France as part of its missions to monitor public health and coordinate epidemiological surveillance.

The Agency’s Perinatal and Early Child Health program is therefore cross-cutting and integrates monitoring, prevention and health promotion. His approach is based on the population according to the life trajectory starting from the first 1000 days to reduce social inequalities in health as soon as possible. The agency is based on the state of scientific knowledge, production of epidemiological indicators and determinants. Finally, based on these foundations, identification and support for the implementation of early interventions, especially with regard to vulnerable groups, is developed. For example, the PANJO intervention currently implemented at PMI aims to support parent-child attachment.

Informing future parents and parents of young children, raising awareness about the challenges and opportunities of the period called 1000 days is another important focus. The campaign “Being a parent also means asking yourself questions” will be broadcast again from September 26. Its aim is to raise awareness of this important period among parents and parents-to-be and to promote the tools available on the website 1000-premiers-jours.fr, launched in September 2021, which provide parents and parents-to-be with reliable information.

The French Public Health closely monitors the health of mothers and children through various repeated surveys (National Perinatal Survey, National Perinatal-DROMS, Epifane 2021, confidential national survey of mothers) with numerous partners including the Ministry of Health and Prevention and Inserm. deaths.)

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Perinatal health surveillance report in France

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[1] 2014-2019 for Mayotte

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