Low birth rate, high neonatal mortality rate, stable caesarean section rate … For the first time, a report published by the French Public Health Agency on Tuesday 20 September describes the state of health in the perinatal periodpregnant woman, fetus and newborn) in the country. It warns of development “worrying” Some indications, within ten years, particularly in France and overseas.
If some of them testify to a “High and stable support level” in France, “The report mentions a heterogeneous situation between the regions, with a deterioration in the overseas provinces and regions.”detailed to AFP by Anne Gallay, director of non-communicable diseases and trauma at public health in France.
First observation: the birth rate decreased in all regions of France, with the exception of Guyana. The number of births decreased from 841,000 in 2010 to 734,000 in 2019. The main causes lie in the increase in the birth age of the mother (from 29.4 years in 2010 to 30.1 in 2019) and in lower fertility among younger women.
Pregnancy diabetes
At the same time, maternal instability appears to be getting worse: the number of births covered by health insurance is slightly lower (96.8% in 2010 compared to 96.0% in 2019). There are more mothers in an irregular situation with state medical aid (AME, 1.6% in 2010; 2.5% in 2019) and homeless mothers (0.58% in 2015 in Ile-de-France; 2.28% in 2019).
Although pregnant women smoked less than twenty years ago, France remains one of the European countries with the highest prevalence of maternal smoking in Europe (16.2% of women who smoke in the third trimester of pregnancy in 2016).
Certain maternal diseases are on the rise during pregnancy and the puerperium, notably disorders related to hypertension (4.5% in 2010; 5.0% in 2019) and gestational diabetes (6.7% in 2010 and 13.6% in 2019). This recent increase is explained in part by changes in screening methods and an increase in the prevalence of risk factors, such as obesity or higher maternal age.
The caesarean section rate has remained stable since 2012 (about 20.2%). As for the rate of episiotomy in vaginal deliveries, it decreased sharply at the same time, both for first-born women, who are considered the first child, (from 29.5% in 2010 to 10.0% in 2019) and for childbirth (from 10.5%). 2.7% over the same period).
Increasing the neonatal mortality rate
Another key note: changes in mortality are contradictory, “so disturbing” For both mother and child, Ann Galley confirmed. Thus, maternal mortality did not decrease significantly between 2007-2009 (9.5 deaths per 100,000 live births) and 2013-2015 (8.1 per 100,000 live births), the date of the latest available data.
Newborn mortality (between 0 and 27 days of age) increased in mainland France, from 1.6 deaths per 1,000 births in 2010 to 1.8 per 1,000 births in 2019. “Work is underway to better understand the causes of these deaths.”, notes Noluwen Regno, head of the perinatal unit at public health in France. The situation can in any case progress, according to her, ‘Many countries with better results’.
In overseas departments and regions, the overall picture looks even more unfavorable. The maternal mortality rate is four times higher than in France, the stillbirth rate is 1.5 times higher and the neonatal mortality rate is two times higher. Guyana and Mayotte are the provinces where the situation is worse.
These results Advocating for increased prevention and promotion of perinatal healthAnd the “Improving access to rights and care, particularly in some territories” Abroad, the report concludes.
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