Perinatal well being: a “worrying state of affairs”, particularly within the Abroad Territories

Perinatal well being: a “worrying state of affairs”, particularly within the Abroad Territories

In a report printed on September 20, Public Well being France factors to the “worrying state of affairs” of perinatal well being in France. “Nice territorial inequalities” are additionally described, with extra “unfavorable” leads to the Abroad Territories.

In virtually ten years, from 2010 and 2019 (and from 2014 for Mayotte), the well being of moms and newborns has undergone adjustments “worrying”throughout being pregnant, childbirth, and even breastfeeding, factors out a report from Public Well being France printed on September 20. Explicit consideration was paid to the abroad departments and areas (DROM).

If sure indicators level to a “excessive and secure stage of assist” in France, the report mentions “nice territorial inequalities” in perinatal well being, significantly within the DROMs the place the symptoms are “unfavorable”. Thus, the maternal mortality charge is 4 instances increased there than in France, the speed of stillbirths, 1.5 instances increased and neonatal mortality, 2 instances increased. A very alarming state of affairs in Mayotte and Guyana.

First statement, the lower in births in all areas of France, from 841,000 in 2010 to 734,000 in 2019. Solely Guyana is an exception. However within the division of South America, follow-up throughout pregnancies leaves one thing to be desired. Screening for sure congenital pathologies, comparable to trisomy 21, is way much less carried on the market than in France. The proportion even decreased between 2011, when 81.6% of pregnancies had been examined, and 2017, when it fell to 69.7%.

The variety of nuchal translucency measurements is usually decrease within the abroad departments, with 86.2% of pregnancies examined in 2017, in comparison with 93.9% in France. One other discovering is that the proportion of girls who had at the least three fetal ultrasounds throughout being pregnant can also be decrease within the DROMs, significantly in Guyana.

The report notes an enchancment on this since 2015, when well being authorities issued suggestions for ultrasound follow-up. Nevertheless, these information solely relate to births coated by medical health insurance. Nevertheless, within the DROMs, the protection charge is decrease and has fallen in ten years, from 87.2% in 2010 to 84.2% in 2019 (96.5% in France). It’s even worse in Mayotte the place solely 31.9% of girls giving start are coated by medical health insurance.

The proportion of births coated by state medical support, reserved for individuals in an irregular state of affairs, has additionally elevated in France and this “extra continuously” in Guyana, Martinique and Guadeloupe.

One other level famous by the senatorial report, the age of moms at childbirth has thus elevated on the nationwide stage, besides in Mayotte the place it has remained secure. It’s 30.1 years in 2019, however within the DROMs, girls give start youthful than in the remainder of France.

Nevertheless, the report recollects,prematurity, low start weight, congenital anomalies are extra widespread when moms are youthful than 15 or 35 and older”.

The proportion of girls with morbid weight problems can also be rising. Within the DROMs, excluding Mayotte, it was 1% in 2010 and rose to 2.7% in 2019, whereas in France it fell from 0.4% to 0.7%. In these territories, moms are additionally extra susceptible to hypertension and its problems throughout childbirth. Greater than 10% of pregnant girls are affected in opposition to 7.4 in France. Some indicators are virtually double these of France: pre-eclampsia (4.5%), extreme pre-eclampsia (1.9%), Hellp syndrome (0.5%) and eclampsia ( 1.7%), three life-threatening problems.

The best charges of postpartum hemorrhage are present in Mayotte, La Réunion and within the Centre-Val de Loire and the bottom in Guadeloupe, Martinique and Corsica.

Reunion has the bottom perinatal mortality charge (kids who died at start or 7 days later), whereas Guyana has the best in France. Typically, it’s increased within the DROMs (17.5 ‰ in 2019) than in France (10 ‰)

Evolution of the perinatal mortality charge by area over 3 rolling years, France, 2012-2019.

©Public Well being France

The mortality of youngsters between their start and the twenty seventh day of life will increase generally and stays extra frequent within the DROMs: from 3.3 deaths per 1,000 births to 4.4 deaths relying on the 12 months (1.8 in France in 2019).

Abroad areas even have the next start charge of low start weight kids, significantly in Mayotte and Reunion: 19.8 and 17.7 per 100 births, in comparison with 12 per 100 births in France. Hexagon. The charges are to a lesser extent additionally excessive in Guyana, Guadeloupe and Martinique, compared with the areas of metropolitan France: 15.0, 15.1 and 15.2 respectively per 100 stay births.

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