A declining birth rate, an increasing neonatal mortality, a stable caesarean section rate… For the first time, a report describes the state of perinatal health in France, with a “worrying” evolution of certain indicators, in ten years , particularly abroad. France.
This 160-page document, published this Tuesday by Public Health France, compiles a series of data on the state of health of pregnant women, the fetus and the newborn during the period from pregnancy to postpartum (the return of diapers), from 2010 to 2019. According to the health agency, it allows for the first time a global description of the state of perinatal health in France.
If certain indicators testify to a “high and stable level of care” in France, “the report shows heterogeneous situations between the territories, with a deterioration in the overseas departments and regions,” said Anne Gallay, director of noncommunicable diseases and trauma. in Public Health France.
Declining birth rate
First observation: a declining birth rate in all regions of France except Guyana. The number of births decreased from 841,000 in 2010 to 734,000 in 2019.
The main reasons lie in the increase in the maternal age of childbirth and in the decrease in fertility among younger women. For all of France, the median age at delivery fell from 29.4 years in 2010 to 30.1 years in 2019.
The precariousness of mothers seems to be worsening at the same time: slightly fewer births are covered by health insurance (96.8% in 2010 compared to 96.0% in 2019). And there are more mothers in an irregular situation with State Medical Assistance (AME, 1.6% in 2010; 2.5% in 2019) and homeless mothers (0.58% in 2015 in Ile-de-France; 2.28 % in 2019).
The highest prevalence of maternal smoking in Europe
Although pregnant women have been smoking for less than twenty years, France remains one of the European countries with the highest prevalence of maternal smoking in Europe (16.2% of women smoked in the 3rd trimester in 2016).
Certain maternal pathologies during pregnancy and postpartum are on the rise, in particular disorders related to hypertension (4.5% in 2010; 5.0% in 2019) and gestational diabetes (6.7% in 2010 13.6 % in 2019).
This last increase is explained in part by changes in screening methods and by the increased prevalence of risk factors, such as obesity or older maternal age.
Increased neonatal mortality
Another important observation: the trends in mortality are contrasting, “even worrying” for both the mother and the child, Anne Gallay underlined. Thus, the maternal mortality rate did not decrease significantly between 2007-2009 (9.5 deaths per 100,000 births) and 2013-2015 (8.1 per 100,000), the date of the last available data.
And neonatal mortality (between 0 and 27 days of life) has increased in metropolitan France, from 1.6 deaths per 1,000 births in 2010 to 1.8 per 1,000 in 2019.
“Work is underway to better understand the causes of this mortality,” said Nolwenn Régnault, head of the perinatal unit at Public Health France. The situation can in any case progress, according to her, “many countries presenting better results.”
In the overseas departments and regions, the general picture is even more unfavorable: a maternal mortality rate 4 times higher than that of mainland France, a stillbirth rate 1.5 times higher, a neonatal mortality rate 2 times higher. Guyana and Mayotte are the departments where the situation is worst.
These findings “argue for a strengthening of perinatal health prevention and promotion,” “better access to rights and care, particularly in certain territories” overseas, the report concludes.
Source: BFM TV
