Blondel B, Supernant K, Du Mazaubrun C, Bréart G
INSERM, U149, IFR69, Unité de Recherches Epidémiologiques sur la Santé Périnatale et la Santé des Femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex.
J Gynecol Obstet Biol Reprod (Paris). 2006 Jun;35(4):373-87. doi: 10.1016/s0368-2315(06)76409-2.
To study trends in the main indicators of health, medical practice and risk factors in France. Population and method. A sample of all births during one week was set up in 1995 (N=13,318), 1998 (N=13,718) et 2003 (N=14,737). We compared data from these three years.
Between 1995 and 2003, there was an increase in maternal age, a development of some characteristics of care (HIV screening procedure, maternal serum screening of Down syndrome, in utero transfers) and an increase in the proportion of caesarean sections, epidurals and spinal anesthesia. The proportion of livebirths before 37 weeks of gestation and the proportion of newborns under 2,500 g slightly increased but the differences were mainly between 1995 et 1998. In 2003, obstetrician gynecologists were the main care providers during pregnancy. However 24.3% of women had their first visit with a general practitioner. For the following visits, 15.4% of women had seen a GP at least once and 26.9% had seen a midwife in maternity unit at least once.
Because of the trends in obstetrical practice and organisation of services, routine national perinatal surveys are useful to show major changes and yield quick answers to specific questions.
研究法国健康、医疗实践及风险因素的主要指标变化趋势。研究对象与方法。选取1995年(N = 13318)、1998年(N = 13718)和2003年(N = 14737)一周内所有分娩的样本。对这三年的数据进行比较。
1995年至2003年间,产妇年龄增加,部分护理特征有所发展(艾滋病毒筛查程序、唐氏综合征产妇血清筛查、宫内转运),剖宫产、硬膜外麻醉和脊髓麻醉的比例增加。妊娠37周前活产比例及体重低于2500克新生儿比例略有增加,但差异主要存在于1995年和1998年之间。2003年,妇产科医生是孕期主要的护理提供者。然而,24.3%的女性首次就诊是看全科医生。在后续就诊中,15.4%的女性至少看过一次全科医生,26.9%的女性至少在产科病房看过一次助产士。
由于产科实践和服务组织的变化趋势,全国性围产期常规调查有助于显示主要变化,并快速回答特定问题。