Beatrice Blondel

..We studied the effects of twins and triplets on perinatal health indicators in the overall population in the 1980s and 1990s in Canada, England and Wales, France, and the United States...

..To describe the trends in multiple maternity rates and the main responsible factors, and to present the main medical risks associated with multiple births...

..A neonatal death certificate was introduced in France in 1997. It provides detailed data on the causes of death and the characteristics of newborn, birth and parents. Our aim was to describe the new results of this certificate...

..This type of survey may also be an appropriate instrument for collecting additional data for health policy evaluations...

..To compare the use of health and social services between children born before 33 weeks (very preterm), children born at 33 or 34 weeks (moderately preterm) and children born at 39 or 40 weeks (full term)...

..To compare rates of preterm birth among multiple births in European countries, to estimate their contribution to overall preterm birth rates and to explore factors which could explain differences between preterm birth rates...

..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...

....

..To compare breastfeeding rates at discharge for very preterm infants between European regions and neonatal units, and to identify characteristics associated with breast feeding using multilevel models...

..Twelve of these indicators were targeted for further development and the other 21 for immediate implementation. A feasibility study, reported in the rest of this issue, was put into place to assess these recommendations...

....

..These could be collected from ART centres and other care providers, or through medical birth registries or national surveys...

..1% had an intrauterine transfer. CONCLUSION: This type of survey carried out every three years can show major changes in health, risk factors and medical practices and can yield quick answers to specific questions...

..The challenge was to define indicators that cover common concerns and have the same meaning within the different European health care systems...

..To improve regionalized perinatal care the spatial location of level III units should be taken into account...

..Very few factors were linked to repeat cesarean sections. CONCLUSION: Various factors are associated with cesarean sections; they express the influence of both unfavorable medical conditions and particular medical care organisations...

..We sought to evaluate socioeconomic disparities in serum screening for Down syndrome and assess whether such disparities are more likely to reflect limits in access or information or, rather, informed decisionmaking...

..These associations persisted in multilevel analyses adjusting for other maternal characteristics. Long distances to maternity units should be a concern to health planners because of the maternal and infant health risks...

..Regional differences in multiple births need to be monitored and used to inform policies aimed at regulating the use of infertility treatments...

....

....

..To describe the changes in the rate of caesarean deliveries before labour among women with term breech presentations in France and to identify the factors associated with this change over two periods: 1972-1995/1998 and 1995/1998-2003...

..To study how individual and regional characteristics might explain regional variations in breast-feeding rates in maternity units and to identify outlier regions with very low or high breast-feeding rates...

..To compare maternal age- and education-specific use of amniocentesis in France and the United States...

..The purpose of our study was to examine how the choice of delivery without an epidural varied in this context according to women's characteristics, prenatal care, and type of maternity unit...

..To assess the impact of being small for gestational age (SGA) on very preterm mortality and morbidity rates by using different birthweight percentile thresholds and whether these effects differ by the cause of the preterm birth...

..A full assessment of the impact of closures on accessibility to obstetric services would require information on how these changes affected available choices for care during pregnancy and delivery...

..CONCLUSION: When the follow-up does not include the initial population in its totality, the socioeconomic difficulties are underestimated and probably also the rate of sequelae associated with very preterm delivery...

..To assess breastfeeding trends in hospital, between 1998 and 2003, according to several characteristics of mothers and maternity units...

..To describe variation across Europe in PERISTAT indicators of health care in the perinatal period, and to assess the comparability of these indicators...

..To assess how exclusive and mixed breastfeeding varied depending on the characteristics of the mother, the newborn, and place of birth...

....

..To assess long-term trends in disparities for prenatal diagnosis of Down syndrome in relation to policy changes...

..To study the impact of the organisation of obstetric services on the regionalisation of care for very preterm births...

..This analysis contrasts the rates and short-term outcome of live births before 32 weeks of gestation in 10 European regions...

..To study trends in smoking before and during pregnancy in national samples of pregnant women and changes in characteristics of smokers over time, and describe the current relation between maternal smoking during pregnancy and fetal growth...

..There has been a consistent trend towards delayed childbearing in most Western countries. We present a review of the current epidemiological understanding of the effects of advanced maternal age on fecundity, maternal and child health...

..To compare rates of postterm birth in Europe...

..To study the clinical, emotional and moral difficulties that French midwives encounter in the labor ward while performing termination of pregnancy (TOP) for fetal abnormality...

..Considering that the number of twin deliveries is rising in our country it is important to be aware of the problems experienced by the families and to improve the way material and psychological help is provided to them...

..1% to 12.0%). CONCLUSION: A significant reduction in the overall rate cannot be achieved without regulating caesarean section use for primiparae. Strategies to change delivery patterns should be aimed at both high and low risk women...

..To compare the opinions of obstetricians who currently use fetal heart rate monitoring (FHRM) by telephone with the opinions of obstetricians in favour of this technique, but who do not use it...

..To study the psychological health of the mothers and their difficulties seven years after the birth of triplets and to compare these results with those obtained at four years...

..We then present the results of a study that explores the potential effects of public policies regarding abortion on state-level differences in the live birth prevalence of Down's syndrome...

....

..To describe the problems encountered with the child, the quality of the marital relationship, the organization of the family and to compare the answers made by mothers and fathers...

..That is how he/she will be able to build his/her identity and future autonomy. It is important to be aware of the problems experienced by the families and to improve the way material help and psychological support are provided to them...

....

..CONCLUSION: Further assessments of the development of triplets are needed; these should be based on larger study samples and should use information from teachers and external observers as well as mothers...

..In a society where breastfeeding is not the norm, women may have difficulties combining work and breastfeeding. Specific actions need to be developed and assessed among mothers who return to work and among employers...

..We aimed to assess the role of maternity unit characteristics on obstetric intervention rates among low-risk women in France...

..We study here how pregnant women's choices interact with the distance they must travel to give birth, individual socioeconomic characteristics and the supply of maternity units in France in 2003...

..In a sample of 44,623 births in a Canadian tertiary hospital, the choice of algorithms makes a substantial impact on both preterm and postterm birth rates, even when EUS was used for discrepancies over two weeks...

..Possible mechanisms are greater body weight, increased susceptibility to complications of pregnancy, sex-linked biochemical processes and earlier conception in the fertile cycle...

....

..This study was undertaken to assess age-specific effects of maternal education on patterns of prenatal testing...

..To study in the French Context women's experiences with a low-stimulation regimen of in vitro fertilisation (Friendly IVF) and to compare them with those of women undergoing standard IVF (S-IVF)...

..To describe the organizational characteristics of antenatal care and their relation to the utilization of health services and perinatal mortality in 13 European countries...

..To compare trends in the use of and the opportunity for making an informed choice, regarding maternal serum screening for Down's syndrome...

..Our objective was to assess the national vaccination rate among pregnant women and to determine the association of vaccination with maternal characteristics, prenatal care, and pregnancy-related health behaviors...

..CONCLUSION: Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance...