Trends in perinatal health in metropolitan France from 1995 to 2016: Results from the French National Perinatal Surveys

J Gynecol Obstet Hum Reprod. 2017 Dec;46(10):701-713. doi: 10.1016/j.jogoh.2017.09.002. Epub 2017 Oct 11.

Abstract

Objective: To study trends in the main indicators of perinatal health, medical practices and risk factors in France since 1995.

Population and method: All live births during one week in 1995 (n=13,318), 2003 (n=14,737), 2010 (n=14,903) and 2016 (n=13,384). Data were from interviews of women in postpartum wards and from medical records and were compared between years.

Results: Between 1995 and 2016, maternal age and body mass index increased steadily. Pregnancies that occurred with use of contraception increased from 7.4% in 2010 to 9.3% in 2016. Smoking during pregnancy (16.6%) did not decrease since 2010. The frequency of more than three ultrasounds during pregnancy was 48.5% in 1995 and 74.7% in 2016. Deliveries in large public hospitals increased steadily. The caesarean section rate has been relatively stable since 2003 (20.4% in 2003, 21.1% in 2010 and 20.4% in 2016). The rate of induction of labour was 22% in 2010 and 2016. Overall, 83.8% of women had epidural analgesia/anaesthesia in 2016. Rates of pre-term birth in 2016 ranged from 7.5% among all live births to 6.0% among live born singletons; for singletons, this rate increased steadily from 1995 to 2016, whereas there was no clear trend for low birth weight. Exclusive breastfeeding decreased from 60.3% in 2010 to 52.2% in 2016.

Conclusion: Routine national perinatal surveys highlight successful policies and recommendations but also point out some health indicators, practices, preventive behaviours and risk factors that need special attention.

Keywords: Birth-weight; Delivery; Gestational age; Maternal characteristics; Prenatal care; Preventive behaviour.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Epidural / trends*
  • Birth Weight*
  • Cesarean Section / trends*
  • Female
  • France / epidemiology
  • Health Care Surveys
  • Hospitals, Public / trends*
  • Humans
  • Infant, Newborn
  • Labor, Induced / trends*
  • Maternal Age*
  • Middle Aged
  • Perinatal Care / trends*
  • Premature Birth / epidemiology*
  • Urban Population / trends*
  • Young Adult