[20 years of perinatal epidemiology. The clinician's viewpoint].

Three periods are described. The first is the period of perinatality from 1971 to 1981 during which the precise objective was to reduce perinatal mortality and morbidity based on actions proposed after cost-effectiveness analysis and early surveys in France to evaluate the effect of these actions. This plan allowed a new policy including prevention of prematurity and improvement in delivery conditions. National surveys have shown a reduction in prematurity rates and perinatal mortality. The second period was a wait-and-see period with the abandon of national actions, but also a transfer of responsibility for perinatal health to the different departments. Certain departments developed perinatal actions:actions in Martinique and Guadeloupe are described together with the early audit on perinatal care in Seine-Saint-Denis. The third period, the current period, began in 1994 when the government proposed a new perinatality plan based on a new perception of maternal mortality risk and a come back of the idea of a collective approach to safe birth.